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HE
MARYLAND
PHARMACIST

Official Journal of
The Maryland
Pharmaceutical
Association

January, 1982
VOL. 58

NO. 1

MARYLAND —
PHARMACEUTICAL ,

A, \ ASSOCIATION
\%

Happy Birthday—MPh.A.

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746

JANUARY, 1982 VOL. 58 NO. 1

CONTENTS

3 President's Message
4 Maryland Pharmaceutical Association 1882-1982

12 Purified Insulins, What’s the Difference?
— Marvin Oed

13 Drug Product Selection Act

14 Getting the Facts for Income Tax Reporting
— William C. Greene

20 Trafficking in Look-Alikes
— Laurence B. Golden

28 Abstracts

DEPARTMENTS
31 Calendar

31 Classified Ads

26 Letters to the Editor

ADVERTISERS
30 Credential Leasing 17 Mayer and Steinberg
23 District Paramount Photo 31 Selby Drug Co.
10 Eli Lilly and Co. Life LEG
22 Loewy Drug Co. 8 3:P2:MSCor
19 Maryland News Distributing 18 Upjohn

Change of address may be made by sending old address (as it appears on your journal) and new
address with zip code number. Allow four weeks for changeover. APhA member — please include
APhA number.

The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Pharmaceutical
Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual Subscription — United
States and foreign, $10 a year; single copies, $1.50. Members of the Maryland Pharmaceutical
Association receive The Maryland Pharmacist each month as part of their annual membership
dues. Entered as second class matter at Baltimore, Maryland and additional mailing offices. Post-
master: send address changes to: The Maryland Pharmacist, 650 West Lombard Street, Baltimore,
Maryland 21201

Soe

DAVID A. BANTA, Editor

BEVERLY LITSINGER, Assistant Editor
ABRIAN BLOOM, Photographer
Ya) ne
Officers and Board of Trustees

1981-82

Honorary President

JOHN C. KRANTZ, JR. — Gibson Island
President

PHILIP H. COGAN — Laurel
President-Elect

MILTON SAPPE — Baltimore
Vice-President

IRVIN KAMENTZ — Baltimore
Treasurer

MELVIN RUBIN — Baltimore

Executive Director

DAVID BANTA — Baltimore

Executive Director Emeritus

NATHAN CRUZ — Baltimore

TRUSTEES

SAMUEL LICHTER — Chairman
Randallstown

WILLIAM C. HILL (1984)
Easton

GEORGE C. VOXAKIS (1984)
Baltimore

VINCENT REGIMENTI (1983)
Severna Park

S. BEN FRIEDMAN (1982)

Potomac

RONALD SANFORD (1982)
Catonsville

DUDLEY DEMAREST, SAPhA (1982)
Baltimore

EX-OFFICIO MEMBER
WILLIAM J. KINNARD JR. — Baltimore

HOUSE OF DELEGATES

Speaker

MADELINE FEINBERG — Kensington
Vice Speaker

JAMES TERBORG — Aberdeen

MARYLAND BOARD OF PHARMACY

Honorary President

I. EARL KERPELMAN — Salisbury
President

BERNARD B. LACHMAN — Pikesville
ESTELLE G. COHEN — Baltimore
LEONARD J. DeMINO — Wheaton
RALPH T. QUARLES, SR. — Baltimore
ROBERT E. SNYDER — Baltimore
ANTHONY G. PADUSSIS — Timonium
PAUL FREIMAN — Baltimore
PHYLLIS TRUMP — Baltimore

THE MARYLAND PHARMACIST

President's Message

Where We've Béen re Were Going

Remembering where we’ve been—deciding where we’re going. This is a fitting theme for the
January 1982 issue of the Journal of the Maryland Pharmaceutical Association. We are entering the second
century of our existence. What an ideal time for reflection and resolution, for pondering and planning, for
contemplation and commitment.

As in any year, many a pharmacist will adopt New Year’s resolutions, but this year our profession
has a special opportunity to enact particularly noteworthy policy resolutions to set the tone for the next
centennial. I hope that the membership will give a great deal of thought to where they want to be in the
future and recommend resolutions to the MPhA Resolution Committee. They will then format the resolu-
tions and present them to the House of Delegates for consideration and adoption.

Back in 1882, the pharmacist spent a great portion of his time deciding what medications would be
best for each patient and administering to their needs. In subsequent years we moved to the stage where
the patients took their pains and problems to the physician. The physician in turn would provide the
pharmacist with the directions for dispensing the appropriate prescription. The pharmacist would not
have discussed the medical aspects of the medication with the patient for fear of violating the prerogatives
of the physician. Now, we are one hundred years later at the dawning of clinical pharmacy. The pharma-
cist plays a major role in triage, the physician diagnoses and the pharmacist prescribes the regimen and
monitors the patients’ responses. Save for innovative technology, is this significantly different than it was
a century ago? Have we made a complete cycle?

Many things have happened since the Association was formed on October 5, 1882, some 20 years
before pharmacy laws were enacted in Maryland. We were established for the ‘‘mutual protection of
pharmacists.’’ We now need unity as much as ever, but for different reasons. The remaining issues of the
MPhA journal will unveil many of the problems and triumphs that Maryland Pharmacists have had in the
past. These same journals will provide documentation of where we.are and where we are going so that one
hundred years from today, historian pharmacists will have the basis for meaningful analysis. A sub-
sequent journal this year will carry a roster of our membership which will serve our needs today and
document for posterity the names of those who feel that there is a need to support their profession. Those
same individuals will receive a membership certificate commemorating our centennial. It is a one time
issuance and I am sure it will prove to be a collector’s item. There will be other memorabilia to add to our
prized possessions as well as to present to others to have as cherished mementos.

Beyond this, we as pharmacists in the state of Maryland, during the 100th year of the Maryland
Pharmaceutical Association have the unique opportunity and vehicle to promote our profession with
earned pride. We will continue to grow (new members are joining at the greatest rate ever), we will
continue to represent the pharmacists of this state at the legislature, professional seminars and educa-
tional programs will continue and pharmacists will stay informed through the Association on professional

issues both statewide and nationally.
Lg Vee, an

Philtp Cogan,

PRESIDENT

Remembering Deciding
/ Whe

JANUARY, 1982 3

Maryland Pharmaceutical
Association 1882-1982;
Pharmacists in Maryland for

The pharmacists of Maryland
began to organize the Maryland
Pharmaceutical Association in
1882. Called together in Baltimore
from Cumberland, Hillsborough,
Gaithersburg, and other areas of
the state, seventy-three pharma-
cists were united to serve the pub-
lic interest and improve their cho-
sen profession.

As in the case of other health
professions, in this period follow-
ing the Civil War, the newly
founded college faculty members
contributed greatly to the new as-
sociation. Most organized colleges
of medicine, pharmacy, and den-
tistry were started in these forma-
tive days of our young Nation, so it
is no surprise to learn the profes-
sors at the Maryland College of
Pharmacy played a key role in the
new organization.

In the 1880's, pharmacy associ-
ations were hindered by the same
communications problems facing
everyone. Travel was by train, by
boat and by horse. Letters and
other written communications were
carried in the same manner.

Pharmacists of the 1880's were
trained by the lecture method (a
short term of a few weeks attending
private lectures) and by the ap-
prentice method (working for a
practicing professional long enough
to know the trade). The college
laboratory of today was unknown
because of the scarcity and ex-
pense of equipment.

Medicines in the 1880's con-
sisted primarily of plant drugs, her-
bal remedies, a few patented med-

4

100 Years

Dr. FAHRNEY’S TEETHING
SYRUP

Je CO) IRE ded ven teh 1h 8S

Quick Relief for Colic

Write for Sample Bottle to
D. FAHRNEY & SON Hagerstown, Md.

THE MARYLAND PHARMACIST

J. Newton Gilbert

Pharmacist

State Circle, Cor. East Street
ANNAPOLIS, MD.

The late Joseph S. Sandler is shown in the pharmacy he operated
at the northwest corner of Baltimore and Ann Streets in Baltimore
from 1910 until 1919.

JANUARY, 1982

icines, and individual concoctions
of chemicals discovered, purified,
measured and packaged in the back
of the pharmacy or doctor’s office.

The education of pharmacists
was intertwined with their associa-
tion with one another. Although the
Maryland College of Pharmacy was
organized in 1840 and began
teaching in 1841 in Baltimore, its
early promoters were physicians
from the Eastern Shore of the State
and Baltimore. Pharmacist Thomas
G. MacKenzie permitted the lec-
tures to be given in his office in the
back of his store at Baltimore and
Gay Street. Baltimore at this time
boasted only 77 drug stores and the
College started with six students.
After holding classes in several lo-
cations there was an increase in the
number of students, and by 1882
the merger of the College with the
University of Maryland was first
discussed. By 1886, a new building
was constructed and occupied by
the College, but the school did not
become a department of the Uni-
versity until 1904.

The Maryland legislature, in
1882, had authorized the Univer-
sity to grant the degree of Doctor or
Licentiate in Pharmacy to one who
had served four years of appren-
ticeship, had attended two full
courses of lectures in the theory
and practice of pharmacy and one
full course in qualitative analysis.

Meetings of pharmacists in the
1880’s permitted them to continue
their professional education, learn
how to prepare new drug products,
exchange sources of supply of in-
gredients and discuss business
problems of the day. Travel meth-
ods prevented the frequent meet-
ings that pharmacists are accus-
tomed to today.

The first officers of the Mary-
land Pharmaceutical Association
were John J. Thompson, president;
John W. Geiger, secretary; and
E. W. Russell, treasurer, all of
Baltimore; but the outlying areas
were represented by three vice-
presidents, C. W. Crawford of
Gaithersburg, Thomas W. Schryer
of Cumberland, and Hugh Duffy of

B

Maryland’s Famous Laxative Medicine

As necessary in the home as bread and salt

Houchens 97 years ago.

Originated from a prescription by Dr. John T.

Hillsborough. Having met at the
College on October 5, 1882 with
professor E. Eareckson as tempo-
rary chairman and professor C.
Caspari as temporary secretary,
they voted to meet again on May 8,
1883 and again on the second Mon-
day of May, 1884.

From these modest first meet-
ings, the Association continued its
annual conventions and special
programs throughout the year.
After its first 50 years, the Associ-
ation celebrated at Ocean City’s
Atlantic Hotel from June 21-24,
1932. At this meeting speakers rep-
resented two national pharmacy
organizations, the U.S. Depart-
ment of Commerce, the sister
schools of medicine and dentistry,
and others. Notably, a special re-
ception was held for past presi-
dents and charter members and to
show appreciation to Dr. E. F.
Kelly, who at this time was secre-
tary of the Association, for 25 years
of service. R. L. ‘‘Bob’’ Swain was
then the editor of The Maryland
Pharmacist.

At the 75th Anniversary, the
Association met at Galen Hall in
Wernersville, Pennsylvania, with
375 persons celebrating the event.
Frank J. Macek was the outgoing
association president and George
M. Schmidt the incoming presi-
dent. Joseph Cohen served the as-
sociation as editor.

The present office of the As-
sociation was built in 1953 and
named in honor of Dr. E. F. Kelly.
It houses the business offices and
the Dr. B. Olive Cole Pharmacy
Museum, honoring Dr. Cole who
served on the faculty of the College
of Pharmacy from 1920 to 1953.

THE MARYLAND PHARMACIST

Officers of the Maryland
Pharmaceutical Association

Presidents

1981 — Philip H. Cogan
1980 — Samuel Lichter

1979 — Ronald A. Lubman
1978 — Stanley J. Yaffe

1977 — Richard D. Parker
1976 — Melvin N. Rubin
1975 — Henry G. Seidman
1974 — Paul Freiman

1973 — Anthony G. Padussis
1972 — Bernard B. Lachman
1971 — Nathan Schwartz
1970 — Donald O. Fedder
1969 — I. Earl Kerpelman
1968 — Samuel Wertheimer
1967 — Milton A. Friedman
1966 — Morris R. Yaffe

1965 — Alexander J. Ogrinz, Jr.

1964 — Solomon Weiner
1963 — William A. Colley

1962 — Victor H. Morgenroth, Jr.

1961 — Norman J. Levin
1960 — Harold M. Goldfeder
1959 — Gordon A. Mouat
1958 — Frank Block

1957 — George M. Schmidt
1956 — Frank J. Macek

1955 — Hyman Davidov
1954 — Lester R. Martin
1953 — Otto W. Muelhause
1952 — Manuel B. Wagner
1951 — William E. Waples
1950 — Howard L. Gordy
1949 — Nelson G. Diener
1948 — Milton J. Fitzsimmons
1947 — Charles S. Austin, Jr.
1946 — Albin A. Hayman
1945 — Harry S. Harrison
1943 — Frank L. Black

1942 — Elmer W. Sterling
1941 — T. Ellsworth Ragland
1940 — Lloyd N. Richardson
1939 — A. N. Hewing

1938 — A. A. M. Dewing
1937 — Robert L. Swain
1936 — Melville Strasburger
1935 — Harry W. Matheney
1934 — Andrew F. Ludwig
1933 — L. V. Johnson

1932 — L. M. Kantner

1931 — Wm. B. Spire

1930 — L. S. Williams

1929 — Geo. W. Colborn, Jr.
1928 — Howell W. Allen
1927 — Harry R. Rudy

1926 — H. A. B. Dunning
1925 — S. Y. Harris

1924 — W. K. Edwards

1923 — C. L. Meyer

1922 — A. L. Lyon

JANUARY, 1982

1921 — R. E. L. Williamson
1920 — G. E. Pearce

1919 — D. R. Millard

1918 — W. H. Clarke

1917 — Eugene W. Hodson
1916 — Thomas M. Williamson
1915 — Geo. A. Bunting
1914 — J. F. Leary

1913 — J. Fuller Frames
1912 — D. P. Schindel

1911 — James E. Hancock
1910 — Charles Morgan
1909 — John B. Thomas
1908 — W. M. Fouch

1907 — Owen C. Smith

1906 — J. E. Hengst

1905 — M. A. Toulson

1904 — H. Lionel Meredith
1903 — W. E. Brown

1902 — J. Webb Foster

1901 — Louis Schulze

1900 — Wm. E. Turner
1899 — A. R. L. Dohme
1898 — Robert S. McKinney
1897 — W. C. Powell

1896 — H. B. Gilpin

1895 — Henry J. Hynson
1894 — John F. Hancock
1893 — John Briscoe, M.D.
1892 — John Briscoe, M.D.
1891 — Columbus V. Emich
1890 — E. M. Foreman
1889 — M.L. Byers

1888 — J. Walter Hodges
1887 — William Simon, M.D.
1886 — A. J. Corning

1885 — E. Eareckson, M.D.
1884 — D.C. Aughinbaugh
1883 — J. J. Thomsen

Secretaries

1977-1982 — David A. Banta
1961-1977 — Nathan I. Gruz
1953-1961 — Joseph Cohen

1942-1952 — Melville Strasburger

1907-1942 — E. F. Kelly

1906 — Owen C. Smith
1905 — Louis Schulze
1904 — Owen C. Smith
1903 — Louis Schulze
1901-1902 — Owen C. Smith
1900 — Louis Schulze
1897-1899 — Charles H. Ware
1896 — Henry Maisch
1895 — J. F. Hancock

1889-1894 — John W. Geiger
1884-1888 — M. L. Byers
1883 — John W. Geiger

Treasurers

1980-1982 — Melvin Rubin
1977-1979 — Anthony G. Padussis
1963-1976 — Morris Lindenbaum
1963-1955 — John F. Wannenwetsch
1954-1955 — Gordon A. Mouat
1937-1953 — J. F. Wannenwetsch
1930-1936 — Harry S. Harrison
1924-1929 — G. P. Hetz

1914-1923 — S. Y. Harris
1907-1913 — J. W. Westcott

1906 — G. C. Wisotzki
1902-1905 — H. R. Rudy
1901 —— Jo Re BECK

1899-1900 — W. M. Fouch
1896-1898 — D. M. R. Culbreth
1895 — Henry B. Gilpin
1886-1894 — Samuel Mansfield
1883-1885 — E. Walton Russel

Editors

1977-1982 — David A. Banta
1961-1977 — Nathan I. Gruz
1953-1961 — Joseph Cohen
1939-1952 — Melville Strasburger
1925-1939 — Robert L. Swain

—~

be ay
area ecics

Blood Poison

After Approach of Death, New Life
by Taking Hood's.

Ee ae
e yee

Mr. Wm. EF. Greenholts
Baltimore, Md.

“For four years I was in Intense suffering
with an abscess on my thigh. Jt discharged
freely and several times

Pjeces of Bone Came Out,
Last February I had to take my bed for four
weeks, and then {twas I beg:in to take Hood's
Sarsaparilla. I soon got on my feet, but was
very weak and went to the Maryland University
hospital, whero they said my trouble was chronie
Dlood poisoning 2nd gnve me little hope. I re
turned home and continued taking. Hood's. I
have used six bottles and the abscess has en
tirely disappeared, and I have been in
Fine Health Ever Since.

I know if ithad not been for Hood’s Sarsapa
rilla I should be in my grave. I hava gained ta
weight from !47 9 year 4yc to 170 pounds taday.

Hood s*"Gures

I praise Wood's Sarsaparilla for it ail.’ Ww. B,
GREENHOLTZ, 1312 (funover St, it:.ttimore, Md.

Introducing...
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Utilizing Digital Equipment
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including retail pharmacy,
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accounts receivable systems.

Features include; complete
alpha search, drug interaction
and allergy monitoring, drug
utilization and inventory control
and complete third party edits
and billing services.

Accounting packages are
available, and the System is
compatible with point of sale
terminal applications.

thats
not
alone

the PHARMASERY ”

In-House
Pharmacy System

The Pharmaserv Stand-Alone
System is now part of 3 P M’s
vast electronic network, which
provides weekly price updates
and centralized tape to tape
third party claims processing.
As an exclusive feature, On-
Line users can be upgraded
from the On-Line System to the
Stand-Alone computer.

3 P M, already the nation’s
largest processor of third party
drug claims, is now the most
complete provider of computer
services to the pharmacy
profession.

For information call:

215-337-7089

Or

1-800-521-1758

3 P.M., Inc.

King of Prussia Office Center
1018 West Eighth Avenue
Suite C

King of Prussia, PA 19406

NE MARYLAND
UNDRED \”
ARS

THE CENTENNIAL CELEBRATION COMMITTEE
OF THE

MARYLAND PHARMACEUTICAL ASSOCIATION
INVITES YOU TO PARTICIPATE

IN A FUND-RAISING PROJECT TO SUPPORT THE

ESTABLISHMENT OF AN APPROPRIATE SIGN
TO BE PLACED BEFORE THE

KELLY MEMORIAL BUILDING

This impressive permenant addition to the landscape of the Building will advise the public of the
Building’s purpose and the availability to the public of the B. Olive Cole Mueum and Library Facilities.

Contributions to the Committee’s Celebration Fund will also be used to establish a Memorial
within the Building to honor William Proctor, the father of American Pharmacy and David Stewart, the
first American Chair in Pharmacy. The Committee is also seeking contributions from other pharmacy
organizations in Maryland and allied health care organizations.

If you wish to participate in this important Centennial Project, please make checks payable to the
‘**M.Ph.A. Centennial Celebration Fund”’ and send to M.Ph.A., 650 W. Lombard St., Baltimore,

Maryland 21201.

KELLY MEMORIAL BUILDING

cae

a 2
ee 2 |

You really have a lot to offer...

The most complete line of insulins

Your insulin patients vary greatly in their
specific requirements or insulin. Not
only is daily dosage a factor in achieving
satisfactory control, but duration of insu-
lin action is also. The Lilly line of insulin
products is so complete that it can meet
the needs of virtually all insulin-
dependent diabetics.

ILETIN I

For most diabetics . . . Iletin I

All Lilly insulin preparations bearing the
trademark Iletin I contain a mixture of
beef and pork insulin. The majority of
diabetics manage their diabetes most ef-
fectively by using one or more of the
many forms of Lilly insulin that are cur-
rently available. In 1980, Lilly improved
the purity of its insulin products signifi-
cantly, so that all forms now contain less
than 50 parts per million of proinsulin
(proinsulin content is the standard mea-
sure of insulin purity). The “single-peak”
lletin sold between 1972 and 1980 hada
proinsulin content of <3000 parts per

million.
Ea

For diabetics with special needs...
Hetin Il

lletin II products are insulins derived from
only one animal source—either beef or
pork. The use of Iletin II, Pork, or Iletin II,
Beef, is generally reserved for patients
who demonstrate a clinical need for
single-species insulin. I[letin II products
are in a new class, recognized as purified
insulins. All purified insulins contain <10
parts per million of proinsulin.

ILETIN I

beef-pork insulin =x purified pork insulin
purified beef insulin
PE ea insulins that maximize control — {iheprojegonon request

THE MARYLAND PHARMACIST

Your cashiers have met their match. TEC’s
new M-2200 is here, a programmable, expand-
able POS system that can take all the punishment
your hard-working employees can dish out.

After all, the M-2200 is from TEC, the
same company whose dependable cash registers
have become the world’s best sellers.

And you'll be giving our M-2200 quite a
workout. It can be a standalone terminal offering
more than 250 price look-ups, programmable
check validation, and full cashier accountability.

It can provide register to SAPS totals
consolidation and print .
out six different man-
agement reports at the
phenomenal rate of 3
lines/sec. It can trans-
fer this information
over phone lines to

Ea

JANUARY, 1982

the central computer. It can even transmit and
receive data through a TEC M-2200 master
terminal.

TEC’s dot matrix printer gives clean, crisp
impressions; and because register tape is pulled
instead of pushed through, jamming is virtually
eliminated.

For a no-obligation demonstration or more
information, call the nearest member of TEC’s
dealer network —450 trained professionals from
coast to coast. He’s in the yellow pages. Or call
the nearest TEC office listed below.

Your POS terminals should take the beating,

| not your profits.

Atlanta (404) 449-3040 New York (516) 364-3690
Chicago (312)693-0080 SanFrancisco (415) 873-1810
Dallas (214) 350-7861 Los Angeles (213) 320-8900

Purified Insulins, What’s the
Difference?

by Marvin Oed, Pharm. B.S., P.D.

There has been considerable publicity as well as
some confusion regarding the so-called purified insu-
lins.

This article is not intended to be an exhaustive study
of insulin differences, but should remove some of the
confusion and enable the practitioner to make valid
comparisons among the several insulin products avail-
able.

The purity of insulin can be compared in at least
three different ways: the species source of the insluin,
the modifiers used in the insulins and the pro-insulin
content.

TABLE 1. INSULIN SOURCE

Manufacturer/Brand Species Source
Lilly Hletin | (all) Beef/Pork
Lilly Iletin II (all) Beef
Lilly !letin II (all) Pork
Nordisk (all) Pork
Novo—(all except Lentard) Pork
Novo—Lentard only Beef/Pork
Squibb* Beef/Pork

* More highly purified and single species source
insulins were about to be released as this article
was being written and should be currently available.

Table 1 compares the source of the currently avail-
able insulins. Pork insulin is closer to human insulin
than beef, differing in only one amino acid. Beef, being
more abundant in the United States is more available
and, therefore, less expensive than pork. If an indi-
vidual is satisfactorily controlled, there is no reason to
change insulin to that of a different source. A loss of
control is possible and monitoring is suggested if a
change is made. A change in species source might be
indicated in those diabetics showing allergic reactions
or insulin sensitivity.

Insulins have been modified in various ways to ex-
tend the duration of action and reduce the number of
daily injections required. Zinc crystals, protein
molecules and buffers are added to modify insulins for
this purpose.

Table 2 compares the modified insulins. Regular and
Lente insulins are the least antigenic because they con-
tain no protein. In increasing order of antigenicity is
globin, NPH and protamine zinc.

As with species source, there is no proven reason to
change the stabilized diabetic from one modified insulin
to another.

12

TABLE 2. MODIFIED INSULINS

Insulin Type Protein Modifier Zinc/Buffer

| Regular
Actrapid (Novo) NO NO
Velosulin (Nordisk)

II. Lente
Semi Lente
Ultra Lente
Lentard (Novo) NO YES
Monotard (Novo)
Ultratard

LE NPH
Insulatard (Nordisk)
Mixtard (Nordisk)

IV. Protamine Zinc VES YES
Globin VES YES

YES NO

The real confusion began as Lilly introduced a more
purified product (Iletin I) to replace Ietin and a highly
purified product (Iletin II) along with two foreign man-
ufacturers Novo and Nordisk introducing highly
purified insulins.

There can be several contaminents in insulin. The
FDA defines purity on the content of one of those con-
taminents, proinsulin. Any product containing less than
10 parts per million of proinsulin is considered to be
purified insulin.

Table 3 compares the proinsulin content of the cur-
rently available insulins.

There is no conclusive evidence showing significant
clinical benefit for the highly purified insulins in the well
controlled diabetic.

TABLE 3. PURITY

Pro-Insulin Pro-Insulin
Parts Per Million Parts Per Million

Manufacturer/Brand FDA Other Source*

Lilly lletin | <50 <10

Lilly lletin Il Beef <10 <10

Lilly Iletin 1] Pork <10 <10

Squibb** <10000 See footnote**

Novo <10 <1

Nordisk <10 Not detectable

* Other sources are manufacturers data or in-house manufacturing
specifications.

** A new insulin containing not more than 25 ppm of proinsulin was
due to be released as this article was being written. A highly purified
insulin, not more than 9 ppm of proinsulin is to be released later in the
year.

THE MARYLAND PHARMACIST

The FDA recommends that the use of purified insu-
lin be primarily considered for patients in whom con-
ventional insulins are not satisfactory. This patient
population includes:

e@ Patients with local or systemic allergic reactions to
conventional insulins

e@ Patients with lipidodystrophy caused by conven-
tional insulin therapy

Those diabetics switched to purified insulin should
be monitored to determine if a change in dosage is re-
quired.

It should be remembered that most patients use
urine glucose levels to monitor therapy. Those levels
may not correlate well with blood glucose levels. A pa-
tient showing negative and trace urine levels could be
switched to a purified insulin and perhaps not be aware
of a significant decrease in blood glucose. Monitoring of
blood rather than urine levels is the way to avoid a
potentially serious hypoglycemic reaction.

It would seem advisable that a diabetic expected to
be on insulin for a short time be given the highly purified
insulins to avoid sensitization should insulin be needed
permanently in the future.

For the average diabetic, well controlled on con-
ventional insulin, there seems to be no proven rational
reason to change to the more expensive highly purified
products.

If there are no problems in the well controlled insu-
lin dependent diabetic, do not look for them by making a
change. The newer insulins warrant a trial in the prob-
lem diabetic.

The Elder Ed Program at the University of Maryland School of
Pharmacy has a new consumer pamphlet available entitled
“The Care Giver’s Medication Guidelines.”’ The information
presented is valuable to an individual who cares for an elderly
family member or friend. For information contact: the Elder Ed
Program, U. of Md. School of Pharmacy, 636 W. Lombard St.,
Baltimore, Md. 21201.

JANUARY, 1982

The Drug Product
Selection Act

Effective July 1, 1979

Article 43—Health
Section 273A

(1) In filling a prescription for a brand name prod-
uct, a pharmacist may dispense a different, lower cost,
drug product of the same dosage form and strength if the
different drug product is generically equivalent.

(2) The pharmacist may not select an equivalent
drug product unless its price to the purchaser is less
than the price of the prescribed drug product.

(3) Any pharmacist who selects an equivalent drug
pursuant to this section incurs no greater liability in
filling the prescription by dispensing the equivalent drug
product than would be incurred in filling the prescrip-
tion by dispensing the brand name drug prescribed.

The Department of Health and Mental Hygiene shall
establish and maintain a drug formulary of equivalent
drug products. The formulary:

(i) Shall list all drug products that the Commissioner
of Food and Drug, United States Food and Drug Ad-
ministration, has approved as safe and effective, and
has determined to be therapeutically equivalent;

(ii) shall list all drug products that were not subject
to premarketing approval for safety and effectiveness
under the Federal Food, Drug and Cosmetic Act, 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 equiva-
lence; and

(iii) May list additional drug products that are deter-
mined by the Department to meet requirements ade-
quate to assure product quality and therapeutic equiva-
lence; and

(2) Provide for revision of the formularies are neces-
sary but not less than every 6 months; and

(3) Provide for distribution of the formularies and re-
visions to all pharmacies and prescribers licensed in this
state and to other appropriate individuals.

Department of Health and Mental Hygiene shall:

(1) Assess the need for public education regarding
the provisions of this section;

(2) Provide for that education if appropriate; and

(3) Monitor the effects of this section peri-
odically.

EDITOR’S NOTE
The Positive Formulary was recently mailed to

all Pharmacies in the state. We are reprinting the
DPS act as a reminder of the provisions in force
for Drug Product Selection.

From the SBA

Getting the Facts for Income
Tax Reporting

by William C. Greene
Certified Public Accountant, Wellesley, Massachusetts

Summary

When the facts are in proper order, Federal income tax reporting is
greatly simplified. Proper recordkeeping procedures are the key to
accumulating the information necessary for computing the return
schedules and the tax. Although no specific records are required by the
Internal Revenue Service, the owner-manager of a small business must
be able to prove the statements made on the tax return. This paper
gives suggestions on bookkeeping techniques that can affect taxes as
well as simplify the task of accumulating necessary information.

April 15—Income Tax Day—is a mirror that reflects
all the business days of the year for sole proprietors and
partners. It is a confused reflection for some owner-
managers of small firms because of poor recordkeeping.
It is aclear reflection for other owner-managers because
of good recordkeeping.

Day by day, week by week, and month by month,
good records accumulate the facts you, the owner-
manager, need for income tax reporting. These facts
help you to report your income properly, to take proper
tax deductions, and to back up that report should you be
asked to do so.

No Set Records Required

The Internal Revenue Service [IRS] prescribes no
specific accounting records, documents, or systems.
However, the IRS requires that you maintain perma-
nent books of account or records which can be used to
identify your firm’s income, expenses, and deductions.
Where inventories are factors in determining income
correctly, or when travel and entertainment deductions
are taken, special supporting details are required.

Although IRS requires no particular form of records,
your records must be accurate and reflect taxable in-
come and allowable deductions. Records must also be
kept so that they are available for inspection by IRS
officers.

In most tax matters, the burden of proof lies with the
taxpayer. Therefore, your records must reflect all your
income and all your expenses, just in case they are in-
spected by an IRS agent. Otherwise, IRS may disallow
any deductions which you have made and cannot sub-
stantiate. As a result, you may have to make an addi-
tional tax payment.

14

In addition, if you have adequate records, all the
facts you need for filing a tax return are easily accessi-
ble. You are less likely to make a late filing for which
there are severe charges and penalties. Moreover, you
remove any suspicion of willful negligence and fraud for
which a person can be fined or imprisoned.

A Simple System

If your small business is a sole proprietorship, you
can use a simple set of records to capture facts for in-
come tax reporting. Such a system consists of a check
book, a cash receipts journal, a cash disbursements
journal, and a petty cash fund.

Check Book. All funds that pass in and out of your
store or service shop should go through a checking ac-
count which you set up for your business. (The
owner-manager should handle personal expenses in a
separate checking account.) When used with your other
records, the check book helps you to prove how much
money was handled, how much was taxable income,
and what amounts were deductible for income tax re-
porting. You should reconcile your bank statement
monthly, using the proof totals from your receipts and
disbursements journals to check your work.

Cash Receipts Journal. All receipts should be en-
tered in a receipts journal. In this manner, income that
is not realized from sales—for example, advertising
allowances—is separated from receipts that have to be
reported as ‘‘gross receipts or gross sales.’’ Sales taxes
which you collect for the local or State government
should also be kept separate because they are not busi-
ness income.

Cash Disbursements Journal. All funds that are
paid out should be recorded in a cash disbursements,

THE MARYLAND PHARMACIST

purchases, and expense journal. The best practice is to
enter daily in this journal each check you write. Each
entry should show the nature or classification of the
disbursement—merchandise, office supplies, rent, and
employee wages, to mention a few examples. You can
summarize the expense classifications by extending
each entry into a column for a particular class of ex-
penses and adding the columns monthly. This type of
journal may be created by either posting each check
stub regularly to a line in the journal or by using one of
the “‘one-write’’ pegboards which are available from
several commercial suppliers.

Petty Cash Fund. You should keep a petty cash
fund with voucher slips to document each expenditure.
In this manner, you can prove that cash expenditures—
those of an amount too small to justify writing a check—
are deductible for tax filing. A petty cash fund also elim-
inates your paying for miscellaneous small expenses out
of your own pocket.

Other Records

Under even the simplest system, a fixed asset record
is needed. In this manner, you record all equipment,
buildings, vehicles, and other depreciable assets.
In addition, there is a variety of depreciation tech-
niques such as accelerated methods and special ‘‘first
year’ additional depreciation which, in some cases,
should be used to defer or reduce tax costs. (Investment
credit applicability is also a factor. A good record of
your assets is essential to plan for and get maximum tax
advantages in these areas of fixed assets.) Under the
Revenue Procedure 62-21, depreciation schedules and
records must be kept for at least as long as the replace-
ment cycle to substantiate the guideline lives which IRS
allows.
Employers who withhold taxes from wages have to
keep additional and extensive records. If you have one
or more employees, you may be required to withhold
Federal income tax from their wages. Your payroll rec-
ords must include the amounts and dates of all
employee wage payments subject to withholding taxes.
You should keep such records for at least 4 years after
the date the tax becomes due or is paid, whichever is
later. (For additional details see ‘‘Steps in Meeting Your
Tax Obligations,’ Small Marketers Aids No. 142, free
from SBA, P.O. Box 15434, Fort Worth, TX 76119.)
Corporations and Partnerships. If your business is
a small corporation or a partnership, your records must
cover situations that do not exist in a sole propri-
etorship. In a corporation, the records must show the
salaries paid to its officers and the dividends paid to
stockholders. The owner-manager, as an officer of the

corporation, is responsible for filing an income tax re-

turn for the company and a personal return to pay in-
come tax on salary and dividends received from the
corporation. If the business is a partnership, it files an
information return on Form 1065 indicating the income
or loss assignable to each partner. Each partner then

JANUARY, 1982

files a personal return and includes his or her share of
partnership income with his or her other taxable income.
The legal form of your organization can have a substan-
tial effect on taxes, and both legal and accounting ad-
vice will be important in selecting the best form of busi-
ness for your particular needs.

Retaining Records

You should keep the records which you use to pre-
pare your firm’s income tax return. However, there is
no fixed answer to the question of how long to retain
such records. You should keep them as long as their
contents may become material in the administration of
any Internal Revenue law. Ordinarily, the statute of
limitations for such records expires 3 years after the
return is due to be filed.

Generally, the Internal Revenue Service cannot
bring assessment or collection proceedings for a given
taxable year after 3 years has elapsed from the due date
of the return or the date it was filed, whichever is later.
The major exception to this time period are in cases
where the taxpayer omitted over 25 percent of gross
income or filed a false or fraudulent return.

However, you should keep in mind that this 3-year
period is a minimum. Many of your records should be
kept for a longer period.

Among records often considered permanent are
cash books, depreciation schedules, general ledger,
journals, financial statements and audit reports. Rec-
ords to be retained 6 to 7 years often include accounts
payable and receivable, cancelled checks, inventory
schedules, payroll records, and sales vouchers and in-
voice details.

Copies of income tax returns should always be re-
tained. Retaining records helps the taxpayer as well as
the IRS because it is often to the taxpayer’s advantage
to use carry-back claims and amended returns. In such
cases, you must be able to prove that your tax returns
are correct.

Plan with Records

As the owner-manager of a small business, you
should use your records to plan your income tax. The
government wants you to pay only your legal obliga-
tion—no more and no less.

This fact has been best expressed by the late Judge
Learned Hand, who said, ‘“‘Over and over again courts
have said that there is nothing sinister in arranging one’s
affairs to keep taxes as low as possible. Everybody does
so, rich or poor; and all do right, for nobody owes any
public duty to pay more than the law demands.”

Your accounting system should provide a current
indication of the profitability of your business. Thus,
your records help you to make a sound estimate of tax-
able income for the year, and consequently, the pro-
jected tax bracket of your business. You should review
these figures at least once each quarter during the year

fia\

to see what, if any, steps you can take to minimize your
tax.

When making tax payments, it is essential that your
accounting system provide a basis for your estimate.
Where underpayment has already occurred, the system
should substantiate the timing of income to avoid or
mitigate penalties.

An employee benefit plan may offer tax advantages.
For the smallest entrepreneur, the self-employed re-
tirement deduction can be very beneficial. However, as
in the case of any pension or profit sharing plan, the
decision of whether or not to adopt such a plan or on
what basis, depends on what your accounting system
projects for profits and available cash.

Outside Help

Unless your background includes bookkeeping or
accounting, you should use outside help in setting up
your records. An accountant can help you determine
what records to keep and what techniques will insure
that you don’t pay unnecessary tax.

For example, because of poor records one small
owner unnecessarily included $30,000 of installment
sales as taxable income even though they would not be
earned for 2 or 3 years. At a 22 percent tax rate, more
than $6,500 ‘‘extra’’ taxes were paid.

Inventory costing is another example of the need for
sound records. Your records should allow you to sub-
stantiate a correct but minimum income valuation.

An accountant can also advise you on the most eco-
nomical way of maintaining records. For example, some
small businesses need only a part-time bookkeeper or
can use a bookkeeping service. Still other firms need a
full-time employee to keep records up-to-date.

In addition, accountants and lawyers can advise of
changes in tax laws that may require adjustments in the
kinds of facts necessary for tax reporting.

INDUSTRY RELATIONS COMMITTEE asks
that Association members contact the Committee
with information and examples of products that
present dispensing difficulties. For example: pack-
age or container too small to label without cover-
ing necessary information; or product dilution in-

formation confusing or not legible, etc. The
Committee will research the problem and may submit
it to the USP and FDA’s drug problem reporting
system for correction. Call the office—(301) 727-
0746.

History of the
Drug House

THE DRUG HOUSE, INC. is the outgrowth of a
retail drug store catering primarily to ships in the Port of
Philadelphia, and started by John Smith in 1830. Expan-
sion of his business eventually led to the formation of a
wholesale drug business incorporated as Smith and
Kline Company. Further expansion led to the change to
Smith, Kline and French Company in 1891 and the
Company operated under this trade name until 1929.

In the meantime, manufacturing of pharmaceutical
specialties had become of such importance that separate
divisions were established and, in 1929, Smith, Kline
and French Laboratories became the parent Company
and Smith, Kline and French, Incorporated became the
wholesale subsidiary. The Company, in 1929, merged
with Valentine H. Smith Company; in 1932, Miller Drug
Company of Philadelphia; and in 1936 Aschenbach and
Miller Company. In 1947, N. B. Danforth, Incorporated
of Wilmington, Delaware and in 1952, Mercer Whole-
sale Drug Company of Trenton, New Jersey were pur-
chased.

In 1951, Smith, Kline and French, Incorporated
moved into the most modern and one of the largest
wholesale drug warehouses in the United States. In
1956, a similar but smaller plant was erected in New
Castle, Delaware, a suburb of Wilmington, and the
Wilmington Division started operation in February,
19578

Late in 1965, the Company was acquired from
Smith, Kline and French Laboratories by the three sons
of its former Chairman of the Board, J. Mahlon Buck.
The new owners, who represent the fifth generation of
the original Smith Family in the business, renamed it
THE DRUG HOUSE, INC.

The Company began a period of rapid growth when
in February, 1968, the operations of the Philadelphia
Wholesale Drug Company were merged into those of
THE DRUG HOUSE, INC. In May of 1972, the Com-
pany acquired all of the assets of Hensel & Sons, Inc. of
Harrisburg, plus the Hensel Drug Co. of Johnstown.

In September of 1977, the assets of THE DRUG
HOUSE were purchased by The Alco Standard Corpo-
ration, a major U.S. Corporation headquartered in Val-
ley Forge, Pa. With the added strength of Alco behind
the company, we were able to acquire the Baltimore
Division of The Henry B. Gilpin Co. in July, 1979. The
addition of the Baltimore Division has made your com-
pany one of the largest and most progressive full line,
full service wholesale drug operations in the nation. It
must be the company’s aim, as well as the aim of every
employee to provide our customers with the best ser-
vice available.

THE MARYLAND PHARMACIST

When
was the |
last time

your -

insurance
agent
gave you
a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville. Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
VICTOR H. MORGENROTH, JR. EVERY
YEAR! Usually for more than 20% of

his premium.

VIC is one of the many Maryland pharmacists
participating in the Mayer and Steinberg
MPhA Workmen's Compensation Program
underwritten by American Druggists
Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS,
call or write:

Your American Druggists’ Insurance Co. Representative

9 AMERICAN
ANT” DRUGGISTS’
INSURANCE

Please contact me. | am interested in receiving more

information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. UO Call

OO Write

aa 9. sdbrerme Gane 77 borne

Remember
the summer of 81?

Last summer, four young people joined The
Upjohn Company as part of the NPC Pharmacy
Internship Program.

They added to their educational process...
learned about manufacturing, quality control,
pharmaceutical research, and marketing/sales.

We hope we answered their questions. Cer-
tainly, we took their suggestions to heart.

And when the 10 weeks were over, we parted
knowing that we'll enjoy seeing each other in
the years ahead.

And reminiscing about the summer of ‘81.

© 1981, The Upjohn Company, Kalamazoo, Michigan 49001

University of Michigan University of Wyoming University of Wisconsin-Madison Ferris State College

Bus aoe magaynes, faprbaek books
Gant Comics dnd Come book le dee eth

agatn ot oe ca a 5

That’s the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your Customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

JANUARY, 1982 19

Trafficking in Look-Alikes:
An Update

Laurence B. Golden
Office of Intelligence
Drug Enforcement Administration

Recent federal and state actions have seriously af-
fected the rampant trafficking in look-alikes that has
been sweeping the country. Look-alike distributors,
who began assaulting the nation with a blizzard of cap-
sules and tablets early in 1980, and the manufacturers
who supply them have been dealt a series of regulatory
setbacks that may portend an end to this multi-million
dollar industry.

Look-alikes are carefully designed to resemble or
duplicate the appearance of brand name amphetamines,
barbiturates, tranquilizers, and narcotic pain killers in
both capsule and tablet form. On the street, they are
known by the same names as their dangerous drugs
counterparts: Black Beauties, Dexies, Yellows,
Christmas Trees, and Rainbows. But look-alikes con-
tain only noncontrolled substances such as caffeine,
ephedrine, phenylpropanolamine, acetaminophen, and
other over-the-counter non-prescription drugs.

As the number of mail order and store front
wholesale distributors grew from a mere handful in
early 1980 to more than 150 outlets by November of
1981, the production of look-alikes was reported to have
soared to 30 million dosage units per week. During the
past year and a half, the look-alike industry has flooded
the nation’s campuses and schoolyards with hundreds
of millions of these pilis. Intelligence derived from local
police agencies, hospital emergency rooms, and medical
examiners reveals widespread abuse, especially among
teen-agers and college age youths.

In marked contrast to the methods used by illicit
drug traffickers, look-alike distributors have conducted
extensive advertising campaigns claiming their products
to be both safe and legal. They have utilized full color
brochures, magazine ads, highway billboards, and even
television spots designed to appeal to teen-agers and
young adults. Using commercial mailing lists, dis-
tributors have mailed colorful business cards directly to
young recipients.

The easy availability of look-alikes has encouraged a
climate of acceptance among many teen-agers and has
conditioned them to the daily trafficking, handling, and
consumption of these ‘‘pharmacal stimulants.’’ In many
places, look-alikes have become as much a part of the
drug culture as the shopping center head shop and the
paraphernalia vendor.

As the abuse of look-alikes grew, the public health
dangers of these substances quickly became apparent.

20

It is obvious that the young consumer who thinks that
he has been purchasing ‘“‘speed’’ or ‘“‘ludes’’ and has
become used to taking several look-alike capsules or
tablets at a time in order to ‘‘get the full effect’’ runs the
risk of serious overdose or death if one day he ingests
the same number of real controlled substances. In addi-
tion to this danger, the look-alikes, themselves, can
have serious damaging effects. The number of emer-
gency room incidents attributable to these drugs has
risen dramatically in the past year. More than a dozen
deaths caused by look-alikes have been reported from
around the country. More deaths from caffeine over-
dose and emergency room hypertensive incidents from
severe reactions to phenylpropanolamine may have oc-
curred but have gone unreported.

Although trafficking in look-alikes is not prohibited
by the federal Controlled Substances Act, the Drug
Enforcement Administration considers that the dis-
tribution and sale of look-alikes, as of drug parapherna-
lia, encourages and contributes to drug abuse and drug
profiteering. The look-alike problem is one more facet
of the nation-wide drug abuse problem. For these rea-
sons, the DEA has undertaken a six-point program
against look-alikes. Briefly stated, the six points are:

1. Drafting of a Model Imitation Controlled Substances
Act! for concerned states to adopt.

2. Preparation of documentation describing the prob-
lem, distribution patterns and practices, and other
information to be used in support of the Model Act.

3. Fostering intergovernmental agency cooperation and
providing active support to other agency efforts.

4. Enlisting the support and voluntary cooperation of
the legitimate pharmaceutical industry.

5. Publicizing the DEA initiative and encouraging the
support of parent and community groups.

6. Targetting of states heavily involved in look-alike
distribution and manufacture to encourage legisla-
tive action.

More than a dozen states have enacted or are con-
sidering legislation targetted against the manufacture
and distribution of look-alikes. States with legislation
now on the books include Arkansas, Colorado, Con-
neticut, Delaware, Florida, Indiana, Kansas, Louisi-

‘Copies are available upon request from the Dangerous Drugs
Section, Office of Intelligence, Headquarters, DEA.

THE MARYLAND PHARMACIST

ana, Maryland, North Carolina, Oklahoma, Oregon,
and South Dakota. Some cities, such as Independence,
Missouri, have passed local ordinances prohibiting
storefront look-alike sales. In other state action, the
Attorney General of Illinois has filed complaints against
39 look-alike distributors. To date, he has obtained
verbal agreements from 15 distributors to cease and
desist selling in the State of Illinois and he has obtained
temporary restraining orders against three others.

The legitimate pharmaceutical industry also has
been cooperating in efforts to eliminate the look-alike
problem. The Eli Lilly Company, one of the largest
manufacturers of gelatin capsules, has, since July 1981,
refused to sell capsules to look-alike manufacturers.
Other capsule manufacturers also have indicated a
willingness to cooperate in this effort. The resulting lack
of capsules already has begun to affect the look-alike
distribution chain and some distributors say they can no
longer obtain ‘‘ Yellows’? and *‘Black Beauties.”

Recent actions by federal government agencies are
having salutary effects on the problem too. During the

JANUARY, 1982

past several months, the U.S. Postal Service has filed
complaints against 39 look-alike distributors. To date,
the Postal Service has concluded consent agreements
with nine distributors and has obtained False Repre-
sentation Orders against nine others. The False Repre-
sentation Orders require postmasters to stop the deliv-
ery of all mail to the subject distributors.

The most significant federal action yet taken oc-
curred on September 30, 1981, when the Food and Drug
Administration filed counterfeiting and mis-labeling
complaints against nine manufacturers of look-alike
drugs. With the assistance of U.S. Marshalls in five
states, seizures of equipment, materials, and finished
products were effected at the following locations:

BT Pharmaceuticals, Inc.
Tampa, Florida

Frye Pharmaceuticals, Inc.
Birmingham, Alabama

Jerome Stevens Pharmaceuticals, Inc.
Central Islip, New York

Valley Run Pharmaceutical
Milroy, Pennsylvania

Newtron, Pharmaceuticals, Inc.
Coram, New York

Pharmadose, Inc.
Bohemia, New York

Standard Pharmacal Corp.
Elgin, Illinois

LNK International, Inc.
Hauppauge, New York

VIP Pharmaceuticals, Inc.
Pearl River, New York

An inventory of seized items includes: 15 million
filled capsules, 800,000 tablets, 20 million empty cap-
sules, and over one million dollars worth of equipment
including offset rollers, capsule printers, tablet punches
and dies, and tablet presses. The FDA felt that its case
against a tenth manufacturer, Ketchum Laboratories of
Amityville, New York, was inadequate to support any
enforcement action at that time.

As aresult of the FDA actions, one of the manufac-
turers has already signed a consent agreement to cease
and desist production of look-alikes, and two more
companies are also negotiating consent agreements.
Information on responses by the other manufacturers
was unavailable as of the date of this report.

The actions described above comprise a promising
start toward ending the nation-wide trafficking in look-
alikes. It is too early to make an accurate evaluation of
the overall damage suffered by look-alike traffickers,
but there is room for some optimism. Continuing action
by federal agencies, state and local governing bodies,
the pharmaceutical industry, and the public will be re-
quired to eliminate the look-alike problem from this
country.

21

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M.Ph.A. President Philip Cogan presented a comic monologue Held on November 13, 1981 at the Kelly building, the Coffeehouse
as part of the Fall SAPhA Coffeehouse. starred pharmacy school talent.

&

Anne Myers performed for the overflow crowd. SAPhA uses the Coffeehouse as a fundraiser for its many other
activities.

Maryland was well-represented at the Regional meeting of SAPhA Brian Sanderoff (left) and Taher Sheybani (right) both ran for
in New Jersey. As a result, next year’s Regional meeting will be office at the Regional Meeting.
held in Baltimore.

This page donated b
Rien p ian a 4 Pictures courtesy Abe Bloom — District Photo

Photo Service.

DISTRICT PHOTO INC

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

JANUARY, 1982 23

“Firsts” for the
School of Pharmacy

“x The first school of pharmacy in the South.

s The first Baltimore professional school to place all
faculty members on salaries.

“. The first University of Maryland school to require
written entrance examinations.

“a The first separate course in pharmacy offered in the
United States.

“s The first separate professorship in the theory and
practice of pharmacy in the United States.

“s The first school of the University to occupy a build-
ing purchased by its alumni.

s The first laboratory for physiological drug testing in
America.

«3 The alma mater of the author of the first scientific
paper read before the American Pharmaceutical As-
sociation.

“s The first obligatory American pharmacy school
courses in analytical chemistry and prescription com-
pounding, and the first full-time pharmacology depart-
ment, as well as professorships in these areas.

+ The first school to convene representatives of phar-
macy schools to formulate uniform standards for the
graduation of students which resulted in the formation
of the present American Association of Colleges of
Pharmacy.

« The first to offer extensive training in patient as-
sessment skill to Doctor of Pharmacy students.

“, The first structured Professional Experience Pro-
gram, an externship for students that involves practical
work experiences in community, hospital and institu-
tional pharmacies.

“, The first accreditation conference on pharmacy
schools which led to the establishment of the American
Council on Pharmaceutical Education.

«, The first central nuclear pharmacy in Maryland.

APhA'82 LAS VEGAS

Stock up
on Ipecac!!

Jacquelyn S. Lucy, M.A., M.Ed.
Coordinator, Education/Communications
Maryland Poison Center

Again this year, the Maryland Poison Center, a divi-
sion of the University of Maryland School of Pharmacy,
will be promoting Syrup of Ipecac as part of its obser-
vance of Maryland Poison Prevention Week (MPPW)
(March 14-20, 1982). Last year’s MPPW success was
due largely to the efforts of pharmacists throughout the
state who sponsored displays, contests, programs, etc.
to help in the on-going fight against accidental poison-
ings. This year’s campaign will again call on pharma-
cists. The focus for the 1982 MPPW will be built on
increasing the general public’s awareness of common
medicines (aspirin, tylenol, cough and cold prepara-
tions, laxatives, liniments, etc.) as potential poisons. In
1980 (most current data available), medicines ranked as
the number one poisoning agent for every age group
except those less than one year of age where it ranked
second after plants. Since adults must be aware that an
item is harmful before they will keep it out of reach,
MPPW will concentrate on over the counter drugs fre-
quently involved in childhood poisonings. During
MPPW, the Maryland Poison Center encourages phar-
macists to help increase their public’s awareness of
OTC products: their proper use, storage and dangers
associated with misuse either alone or in combination
with other drugs. Hopefully, awareness of medicines as
possible poisoning agents will lead to preparedness in
case of an accidental exposure. The best preparation
involves having the number of the Maryland Poison
Center on the telephone and a one-ounce bottle of
Syrup of Ipecac in the home. According to preliminary
data for the first six months of 1981, 91% of the calls
involving children under 5 were treated at home. Fre-
quently, this treatment involved the administration of
Ipecac Syrup. Thus, the Maryland Poison Center en-
courages you to recommend Ipecac Syrup for all your
clients with small children.

Another important feature of Maryland Poison Pre-
vention Week is programming. If you conduct or are
willing to conduct programs on poison prevention in
your community, please contact Jacquie Lucy at (301)
528-7184 to register for the MPC speaker’s bureau.

THE MARYLAND PHARMACIST

Announcing the Reactivation of the

EMPLOYEE—EMPLOYER
RELATIONS FORUM

The purpose of the Forum is to deal creatively with the issues in Maryland Pharmacy employer and
employee relations. This Committee of the Association is made up of individuals from a wide variety
of practice settings. We are asking for input on current employment issues from all segments of the
profession. The Forum will act as a “sounding board’ on these issues and will provide some
ombudsman activity.

We are asking for your help in submitting issues to the Forum for
comment and response. If you have a suggestion, idea, or comment,
contact the Employer/Employee Relations Forum at: 650 W. Lombard
St., Baltimore, Md. 21201.

The reactivation of the Employer—Employee Relations Forum coin-
cides with the Association’s Centennial. The Committee decided that

MARYLAND F :
PHARMACEUTICAL there are many favorable sentiments about the profession of pharmacy
pero and what it means to members that are often left unspoken. During the
Centennial year members are asked to express in a positive way what

pharmacy means to them. Here is one such sentiment:

‘‘As we enter the year of the MPhA Centennial, the following sentiments express my pride in our
profession, PHARMACY:

is for pharmacists. And for our patients and patrons, the people for whom we dispense pre-
scriptions and for whom we recommend and sell products for their health and well-being.

is for health profession. As pharmacists, we have the responsibility to counsel and caution our
patrons, the public, on the safe and effective use of drugs and other products.

is for answers. We continue to update our knowledge and stand ready to provide easily
understood answers and information to educate the public and other health professionals.

is for reponsibility. We are working within our associations and the community to benefit
society in controlling drug abuse, misuse, and for the improvement of health care.

is for membership. |Increasing numbers of pharmacists are achieving self-satisfaction by
becoming active members in their associations, participating at meetings, volunteering on
committees, striving for unity of purpose.

is for achievement. From the achievements of the pharmaceutical industry to all of us who
work daily with the fruits of these achievements, we provide what | believe is the best
pharmacy care in the world to our patients and patrons.

is for care, the care and attention we give to our patients and our duties and to putting our
ideals and principles into practice.

is for younger pharmacists who have many great opportunities, now and in the future, to work
with fine colleagues and associations to build an even more rewarding profession.”’

Centennially Yours,
Edward Nussbaum, P.D.

JANUARY, 1982

PEERS Sue

In an effort to control the theft and forgery of St.
Agnes Hospital prescription blanks, we have revised
both their format and procedure for use.

Effective December 1, 1981, we will replace the
present yellow St. Agnes Hospital blanks with two new
blanks.

A blue prescription blank marked *“‘NOT VALID
FOR CONTROLLED SUBSTANCES” which
will be used ONLY for non-controlled drugs.

A pink prescription blank marked *““VALID FOR
GONTROLLED SUBSTANCES ONIZYess These
blanks will be serial numbered and contain space
for the physician's DEA number. ONLY con-
trolled drugs in Schedule II, HI, IV, and V are to
be written on these blanks.

Records will be maintained in the Pharmacy De-
partment of the serial numbers of the controlled blanks
and the area within the hospital to which they are given.

Please note that when we begin to use the new pink
and blue St. Agnes Hospital blanks, there will be a
number of old yellow blanks still in the hands of some of
our patients who have not had the chance to have them
filled. We therefore request that the community phar-
macists exercise professional judgement during the
phase in period.

Bernard Fischer
Pharmacy Director
St. Agnes Hospital

q ry)
{ a
— 7 ‘

Baltimore Radio Stations WCAO-AM and WXYV-FM were recent-
ly honored by the Association for their continuing support of the
Association's public information programming. (left to right)
Larry Wilson, Joseph Cahill and Ron Riley from the station receive
the special award presentation from Charles Spigelmire (far
right).

26

ORDER YOUR PHARMACY
T-SHIRTS TODAY

oe

Ve
ay
2 "a
4 a ‘4

BACK FRONT
LONG SLEEVE SHIRTS with POCKET

Colors: Red, Kelly Green, Navy Blue
Sizes: Small, Medium, Large, XLarge
Price: $10.00 Each includes mailing

Send Orders to: SAPhA

650 W. Lombard St.
Baltimore, MD 24201

ORDER TODAY SIZES AND COLORS
ARE LIMITED

MARYLAND STANDARDS FOR THE REFERRAL
OF PERSONS WITH ELEVATED BLOOD
PRESSURE TO A SOURCE OF MEDICAL CARE

Blood pressure referrals should be determined by taking
the average of three measurements at the same sitting.

ADULTS (Age 18 and older) Use fifth phase for diastolic BP.

> 150/90 mm Hg Refer for either a systolic BP > 150 mm
Hg or a diastolic BP > 90 mm Hg, or
both. Verification of an elevated blood
pressure may take place if practical, but is
not required.

115-129 mm Hg Refer directly to a source of care. Obtain

Diastolic an appointment with a physician within a

(URGENT) week. Make the appointment before the
person leaves the detection site.

> 130 mm Hg Refer the person to a physician or an
Diastolic emergency room immediately.
(MEDICAL EMERGENCY)

YOUTH (Ages 3-17) Use fourth phase for diastolic BP.

> 95th percentile Based on the average of 9 BP measure-
ments on 3 occasions (3 measurements
per occasion). Refer to a source of
medical care.

PLEASE NOTE THAT THE STANDARDS LISTED ABOVE ARE FOR
REFERRAL ONLY AND ARE NOT INTENDED TO SERVE AS
STANDARDS FOR THE DIAGNOSIS AND TREATMENT OF HIGH
BLOOD PRESSURE.

~ I A, These standards for referral have been endorsed by the Maryland

§ BR % High Blood Pressure Coordinating Council, the Maryland High Blood

a Y Pressure Commission, and the American Heart Association, Maryland
Affiliate, Inc

Supported by the Maryland Department of Health and Mental Hygiene under NHLBI contract NO 1-HV-7-2986

THE MARYLAND PHARMACIST

WET

Newly installed BMPA President Frank Marinelli presided over the Dr. Warren M. Ross from the Union Memorial Hospital Fitness
annual membership meeting of the Association held on Center discussed stress and lifestyle at the BMPA meeting.
November 5, 1981.

é

Wesley Frisbie, Technical Director of Respiratory Therapy at The C.E. program was held November 15th at the Baltimore
St. Joseph’s Hospital was one of the presentors at the Continuing Airport. Marvin Oed, Clinical Assistant Professor at the School
Education Coordinating Council's program on Pulmonary of Pharmacy, led the workshop on non-drug management.
Disease.

OF Rea ae

i
Harvey Lybolt, a registered Respiratory Therapist discussed vari- Dr. Susan Bollinger, Director of Respiratory and Pulmonary
ous equipment used to treat pulmonary disease. The Seminar Medicine at Carroll County General Hospital presented a dis-
was designated the Henry Siedman Memorial Lecture. cussion of chronic lung disease.

JANUARY, 1982 Zt

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

BARBITURATES:

The molecular mechanism of action of general
anesthetics, local anesthetics and barbiturates seem to
have similar characteristics. It appears as if barbituric
acid derivatives act as the anion to block the sodium
channels of the neuron, but not in a manner identical to
that produced by the anesthetic agents. Much of this
work in neuronal pharmacology is being carried out
using tissue obtained from frogs. J Pharmacol Exp
Ther, Vole218, pb 9o le

BIGUANIDES:

Although it has become increasingly difficult to ob-
tain phenformin (D.B.I.) and other biguanides used in
the treatment of diabetes mellitus, research into the
mechanisms of action of these compounds continues.
These drugs do not act on the pancreas as do the oral
sulfonylureas, but are thought to exert their hypogly-
cemic activity by increasing muscle uptake of glucose,
decreasing gluconeogenesis, decreasing intestinal ab-
sorption of glucose, increasing anaerobic glycolysis,
and altering membrane-surface potentials in a positive
direction. Such agents require the presence of some in-
sulin in order to be effective and they rarely produce
hypoglycemia. Recent studies suggest that the bigua-
nides also act by increasing the sensitivity of body cells
to insulin. This increased sensitivity seems to follow a
drug-induced increase in the number of insulin receptors
which are found on cell-surface membranes. N Engl J
Med, Vol. 305, #10, p. 563, 1981.

AMINOPHYLLINE:

Aminophylline is one of many methylxanthine de-
rivatives used to treat asthma and related conditions. It
is well known that aminophylline will increase respira-
tory capacity by dilating the bronchioles, but recent
work indicates that it is also capable of increasing the
contractability of the diaphragm thus improving overall
respiratory function. N Engl J Med, Vol. 305, #5, p.
249, 1981.

JET LAG:

Jet lag, a condition common to long distance travel-
ers, is thought to be due to alterations which occur in
diurnal variation or circadian rhythm, brought on by
movement along different longitudes within a short
time. The area of the brain where this biological clock
resides has been determined. Investigators feel it exists
in the supra chiasmatic nucleus within the central ner-
vous system. J Am Med Assoc, Vol. 246, #6, p. 681,
1981.

28

METABOLIC ACTIVITY IN THE LINING
OF THE GASTROINTESTINAL TRACT:

Some drugs have been found to be metabolized as
they pass through the gastrointestinal mucosa thus re-
ducing the amount of active drug which enters the blood
stream after oral administration. Drugs such as ethanol,
flurazepam (Dalmane), and tyramine are oxidized by
the tissue while hydrolysis of aspirin and pivampicillin
has been recorded in the same areas. Estrogenic sub-
stances are glucuronidated and sulfation of various
catecholamines and catecholamine-like substances has
been observed. N-acetylation and methylation are also
known to occur. Among the drugs which are metabo-
lized to some extent as they pass through the gastroin-
testinal mucosa are metoclopramide (Reglan), imip-
ramine (Tofranil), isoniazid, hydralazine (Apresoline),
chlorpromazine (Thorazine), and spironolactone (AI-
dactone). Clin Pharmacokinet, Vol. 6, #4, p. 259, 1981.

VENTRICULAR ARRHYTHMIAS:

Life-threatening ventricular arrhythmias are in-
duced by various stimuli, but a retrospective study of
117 patients has shown that 25 people experienced acute
emotional disturbances within 24 hours of developing
the arrhythmia. The role of the central nervous system
in the development of cardiac arrhythmias may have
been underestimated. J Am Med Assoc, Vol. 246, #3,
ae 8, WEA:

QUINIDINE/DIGOXIN INTERACTION:

Quinidine has been found to displace digoxin from
tissue binding sites thus enhancing activity of the
glycoside. These sites are not associated with the
Na‘t-K*-ATPase enzyme acted on by the glycoside. A
strict structural requirement is present for the interac-
tion as propranolol, verapamil, and lidocaine do not
have the ability to increase digoxin plasma levels. J
Pharmacol Exp Ther, Vol. 218, #2, p. 357, 1981.

SMOKELESS TOBACCO:

There is a tendency today to use snuff or smokeless
tobacco instead of smoking cigarettes. Some feel it is
completely safe to substitute the smokeless tobacco for
the more conventional material but studies show that
the levels of nicotine and cotinine found in the plasma of
snuff users is comparable to that seen in cigarette smok-
ers. Since cigarette smoking is considered to be physi-
ologically addicting, it must be recognized that smoke-
less tobacco may not produce the respiratory complica-
tions produced by cigarette smoking, but it is likely to
be habit forming and thus should not be considered
harmless. Clin Pharmacol Ther, Vol. 30, #2, p. 201,
1981.

THE MARYLAND PHARMACIST

PHYSOSTIGMINE AND MORPHINE:

The major effects of morphine include analgesia, re-
spiratory depression, bradycardia, and hypotension. It
has been postulated that the respiratory and cardiovas-
cular effects of the narcotics are mediated through inhi-
bition of the release of acetylcholine from neurons in the
central nervous system. To investigate this possibility,
physostigmine was administered after the effects of the
narcotic were evident. Physostigmine, a tertiary amine
with the ability to inhibit acetylcholinesterase centrally,
reversed the effects of the narcotic on the respiratory
and cardiovascular system without altering the
analgesic effect. This helps support the concept that
cholinergic receptors are involved in some of the ac-
tions produced by the narcotics. J Pharmacol Exp Ther,
Vol. 218, #2, p. 504, 1981.

VIPERGIC NERVES:

Vasoactive intestinal prolpeptide (VIP) is a regula-
tory peptide composed of 28 amino acids. It relaxes
smooth muscle in the arterioles and thus acts as a potent
vasodilator. It is found in the autonomic nerve fibers
supplying many peripheral tissues and has been termed
a non-cholinergic, non-adrenergic transmitter. VIP has
been called a peptidergic transmitter. The male genital
tract seems to be extremely rich in these fibers and thus
VIP may play a role in nervous control of external
genitalia. Lancet, Vol. II, #8240, p. 217, 1981.

HYPERGLYCEMIA:

Animals were injected with streptozotocin, a prod-
uct used to produce experimental pancreatic damage
and subsequent hyperglycemia. Animals thus treated
were found to experience greater response to morphine
and other analgesics while animals with induced
hypoglycemia were affected in the opposite direction.
The effect is thought to be mediated through central
mechanisms since pharmacokinetic parameters of mor-
phine were not different in the treated animals as com-
pared with those used as controls. J Pharmacol Exp
Ther, Vol. 218, #2, p. 318, 1981.

ALCOHOL INGESTION:

Over 2000 patients were placed into one of four
groups matched for age, sex, race and cigarette smoking
habits. Their alcohol ingestion and mortality rates were
recorded over a ten year study period. Those who re-
ported light drinking habits, (approximately 2 drinks per
day) had the lowest mortality rate. Non-drinkers and
those who used 3 to 5 drinks/day had a mortality rate
50% higher than the former group, and heavy drinkers
had the highest mortality rating. Heavy drinkers died of
cancer, cirrhosis, accidents, and non-malignant respi-
ratory conditions while non-drinkers died most fre-
quently from coronary disease. Smoking increased the
likelihood of death due to cancer and non-malignant re-

JANUARY, 1982

spiratory disease. Ann Inter Med, Vol. 95, #3, p. 139,
1981.

PHENOBARBITAL:

Approximately half of the prematurely born infants
with birth weights of less than 1500 grams are found to
have experienced periventricular or intraventricular
hemorrhage. Infants in this category were treated with
intravenous phenobarbital in doses sufficient to produce
anticonvulsant activity. This treated group experienced
only a 13.3% incidence of hemorrhage thus reflecting a
beneficial effect of the barbiturate therapy. Various
mechanisms have been postulated to explain this effect.
Lancet, Vol. Il, #8240, p. 215, 1981.

MOUNTAIN SICKNESS:

Experience with mountain climbers indicate that
nearly 5% of those ascending the peaks suffer from a
severe form of cerebral or pulmonary edema and half of
those involved in the sport will experience headache,
weakness, nausea, or vomiting. This is especially true
when they climb at altitudes above 14,000 feet. Hypoxia
and alkalosis are frequently seen and are thought to be
closely associated with the development of these
symptoms. The use of diuretics alone (furosemide-
Lasix, spironolactone-Aldactone) is not effective in
protecting against the development of systems, but ac-
etazolamide (Diamox) is beneficial in that it helps re-
move fluid and at the same time keeps the plasma from
becoming severely alkalotic. It is best used prophylacti-
cally and does little to help a patient with established
problems. One must be careful not to ascend too rapidly
because symptoms will appear regardless of precautions
taken. Br Med J, Vol. 283, #6288, p. 396, 1981.

AMIODARONE:

Another antiarrhythmic agent has been utilized or-
ally to help stabilize abnormal ventricular rhythms. The
side-effects include corneal microdeposits, hyper-
thyroidism, blue skin, nausea and bradycardia. Adverse
reactions to amiodarone were noted frequently, but
they usually did not limit therapy. Amiodarone has been
used for several years in other countries. N Engl J Med,
Vol. 305, #10, p. 539, 1981.

RECEPTOR ALTERATIONS:

Chronic administration of beta-adrenergic agents
can lead to reduced activity of the receptors by two
different mechanisms. Heterologous desensitization is
due to a reduction in the synthesis of cyclic AMP, while
homologous desensitization is associated with a loss of
beta-adrenergic binding sites. Oxotremorine is a drug
which acts on the cholinergic receptor with great inten-
sity. Chronic administration of this agent reduces the
number of muscarinic receptors in the cholinergic ner-
vous system and thus leads to the development of toler-
ance via homologous desensitization. J Pharmacol Exp
TREPAN Olm2 18 Ap 53719812

30

Dog work: counting inventory, filing, Keeping up-to-date price lists: that’s not what we
went to school for. But it takes up too many hours in a pharmacist’s day. Bob Bergstein
and Jon Johnson of the Clinton Pharmacy, Clinton, MD, found the answer in the IBM QS/1
System.

Jon Johnson says, “Our Medicaid volume runs in excess of $10,000 per month, and the
turn-around time from submission to cashing of the check has been cut from 34 to nine
days. Our Aetna payments are now paid within days against the old system which took
almost two months. At 2% a month, the interest on that money alone almost justifies the
cost of the machine. ”’

Bob Bergstein concurs. ‘The QS/1 posts charges and third party plans automatically;
prices prescriptions; prints labels — it takes only three seconds to print a refill label,’’ Bob
notes.

Call Jon Johnson or Bob Bergstein at the Clinton Pharmacy, (301) 868-2000.
They'll give you a free demonstration of the QS/1 on the job. It’s easy to lease. Now's the
time.

Credential Computer Associates
P.O. Box 1967 - 2525 N. Seventh Street, Harrisburg, Pennsylvania 17105

THE MARYLAND PHARMACIST

Classified Ads

Classified ads are a complimentary
service for members.

Available from the MPhA Office

— Notification for the patient under the Drug Product
Selection Law

— Heart Shaped Stickers — no charge

— Information on the Blue Cross/Blue Shield Major Medi-
cal Health Insurance Program

— The Association’s Employment Clearinghouse, helping
pharmacists and employers find one another

—1C collection help
— Information on the NEW USP/NF on sale from MPhA

— these and many other services, contact Beverly at the
MPhA Office (301) 727-0746.

The Elder Ed Program at the University of Maryland School of
Pharmacy has a new consumer pamphlet available entitled
“The Care Giver’s Medication Guidelines.” The information
presented is valuable to an individual who cares for an elderly
family member or friend. For information contact: the Elder Ed
Program, U. of Md. School of Pharmacy, 636 W. Lombard St.,
Baltimore, Md. 21201.

P.D.

0
4:2"

ACTUAL SIZE

Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the “P.D.” designa-
tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
Maryland Pharmaceutical Assn.
650 W. Lombard St.
Baltimore, Md. 21201

JANUARY, 1982

COMPANY
WANTS

YOU!!!

FIND OUT WHY 987 PHARMACIES IN ELEVEN
STATES ARE NOW BUYING THEIR PHARMACEU-
TICALS AND HEALTH AND BEAUTY AIDS FROM

SELBY DRUG COMPANY

CALL PERSON TO PERSON COLLECT

201 - 351-6700
TO: MICHAEL ROSENBERG, R.P.
SELBY DRUG COMPANY |

633 DOWD AVENUE
ELIZABETH, NJ 07201

calendar

Jan. 11-18—MPhA Trip to Cancun

Feb. 14—BMPA Dinner-Dance, Blue Crest

April 24-29—-APhA Convention, Las Vegas

March 14 (Sunday)—Alumni Association Dinner
Meeting

June—Maryland Society Hospital Pharmacist,
Seminar Williamsburg

June 20-24—MPhA Centennial Convention,

Ocean City

Every Sunday Morning at 6:30 a.m. on WCAO-AM and 8:00 a.m. on
WXYZ-FM, listen to Charles Spigelmire broadcast the Pharmacy
Public Relations Program ‘‘Your Best Neighbor,”’ the oldest con-
tinuous public service show in Baltimore.

3]

CELEBRATE WITH US

To commemorate its 100th anniversary celebration, the Maryland Pharmaceutical Association is issuing
a special edition, custom designed apothecary jar. For a limited time only, members and friends are
invited to purchase these deluxe containers in recognition of the association's first century of service.

Each glass jar is imprinted with a two-color reproduction of the Maryland Pharmacy banner and the
words: “‘Honos, Firmus, Purissimus — Pharmacy, the Maryland Pharmaceutical Association — 1882-
1982.” The jars are suitable for home or office because of their wide variety of uses:

* For countertops — to store herbs, food-
stuffs

* For desktops — to contain candy or dried
fruit

* For occasional tables — to preserve
snacks or to use as a decorative acces-
sory

No matter how you choose to use this handy

apothecary jar, you will often welcome its

attractive styling and utility. This jar is not

available at any retail store! It has been de-

signed especially for the association and is

destined to become a collectors’ item in the

years ahead. Priced right for the value, you

can save by ordering three or more:

$12.00 — each
$33.00 — for three — $11.00 each
$100.00 — for ten — $10.00 each

Take advantage of this offer now. Simply
complete the order form below and mail it
to:

MhA

650 West Lombard Street

Baltimore, MD 21201

APOTHECARY JAR ORDER FORM

Nainie 282 as Quantity

Address Pees - Amount Enclosed $

DO NOT SEND CASH

Telephone

Return to: MPhA, 650 West Lombard Street, Baltimore, MD 21201

THE
MARYLAND
PHARMACIST

Official Journal of
The Maryland
Pharmaceutical
Association

February, 1982
VOL. 58
NO. 2

David Stewart, First Professor of Pharmacy
in America

— Ben Allen, Ph.D.
OTC Reformulations

Manufacturer Disclosure

Drug Therapy during Pregnancy and in the Pediatric Patient
Sunday March 14, 1982 9:30 a.m.—4:00 p.m.

Sponsored by the CECC

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 WA

FEBRUARY, 1982 VOL. 58 NO. 2

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor

CONTENTS ABRIAN BLOOM, Photographer
Officers and Board of Trustees

3 President’s Message—Philip H. Cogan 1981-82
Honorary President
JOHN C. KRANTZ, JR. — Gibson Island
4 David Steward, First Professor of Pharmacy President
in America PHILIP H. COGAN — Laurel
President-Elect
MILTON SAPPE — Baltimore
1 Vice-President
8 OTC Reformulations IRVIN KAMENTZ — Baltimore
Treasurer
MELVIN RUBIN — Baltimore
Executive Director
DAVID BANTA — Baltimore

Executive Director Emeritus
NATHAN CRUZ — Baltimore

14 Manufacturer Disclosure

26 Tax Information

TRUSTEES

27 Nomination forms SAMUEL LICHTER — Chairman

Randallstown

WILLIAM C. HILL (1984)
DEPARTMENTS ieee

GEORGE C. VOXAKIS (1984)
29 Letters to the Editor EEO

BARBARA BARRON (1983)
Rising Sun, Maryland

7 Calendar S. BEN FRIEDMAN (1982)

Potomac

3] Classified Ads RONALD SANFORD (1982)
Catonsville
DUDLEY DEMAREST, SAPhA (1982)
Baltimore

ADVERTISERS EX-OFFICIO MEMBER

19 Borroughs Wellcome 25 Mayer and Steinberg WILLIAM J. KINNARD JR. — Baltimore

18 Credential Leasing 11 Parke Davis

23 District Paramount Photo 12-13 Roche HOUSE OF DELEGATES

30 The Drug House 22 Sandoz Speaker

28 Lederle Labs 31 Selby Drug Co. MADELINE FEINBERG — Kensington
24 Eli Lilly and Company 20 Upjohn Vice Speaker

10 Loewy Drug Co. 32 3PM Computers JAMES TERBORG — Aberdeen

21 Maryland News Distributing
MARYLAND BOARD OF PHARMACY
lS SSSSrcsmssenseneneeeneeeseeeeee eee

Honorary President

Change of address may be made by sending old address (as it appears on your journal) and new ~ I. EARL KERPELMAN — Salisbury
address with zip code number. Allow four weeks for changeover. APhA member — please include nt
Mpa hunher: President

BERNARD B. LACHMAN — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Pharmaceutical ESTELLE G. COHEN — Baltimore
Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual Subscription — United LEONARD J. DeMINO — Wheaton
States and foreign, $10 a year; single copies, $1.50. Members of the Maryland Pharmaceutical RALPH T. QUARLES, SR. — Baltimore
Association receive The Maryland Pharmacist each month as part of their annual membership ROBERT E. SNYDER — Baltimore
dues. Entered as second class matter at Baltimore, Maryland and additional mailing offices. Post- ANTHONY G PADUSSIS Timoniten

master: send address changes to: The Maryland Pharmacist, 650 West Lombard Street, Baltimore,
Maryland 21201.

PAUL FREIMAN — Baltimore
PHYLLIS TRUMP — Baltimore

2 THE MARYLAND PHARMACIST

President's Message
EB a

Recently, Dr. Farmer, Chancellor of the University of Maryland, Balti-
more Campus, requested a meeting with representatives of your Association's
Board of Trustees. At issue was the future of the Kelly Memorial Building,
headquarters of the Maryland Pharmaceutical Association. Our building is on
the Campus of the University. We were told that University planners would like
to expand the capacity of the University Hospital, including the shock-trauma
facilities. As health care practitioners, we should understand this need and
support the addition. Maryland’s unique and efficient state-wide system for
handling shock-trauma would be compromised if the Hospital could not ex-
pand. Unfortunately for us, our building is in the path of any new addition. We
are optimistic, however, that our Association headquarters operation will not
be jeopardized in the process of construction.

Due to the foresight of the pharmacists who built the Kelly Memorial
Building in 1953, sold it to the University for $1.00 and in return received use of
it for 99 years, we find ourselves in a favorable position. They did an excellent
job of not only designing the building, but also providing for the future of the
profession by their creative handling of the property itself.

Chancellor Farmer, who has an appreciation for the history of pharmacy
in Maryland says he feels compelled to support the interests of the State’s
pharmacists, who themselves have fostered the cultivation of the history of
Maryland pharmacy. For those of you who have not visited your headquarters,
I’m sure you too would be impressed with the museum, the large show globe
and mortar and pestle collections, as well as the other precious artifacts.

At this time, we are waiting for the University to provide us with alter-
natives for our headquarters’ facility. Options may include moving the Kelly
Memorial Building, sharing a building, or constructing a new single unit build-
ing, depending upon the costs involved and the appraised value of our building.
Of course, any major University capital expenditure must be appropriated by the
State Legislature. We have been told that the issue will be decided this legisla-
tive session. If the issue is defeated, it is our understanding that the University
will not seek authorization to expand the hospital in the foreseeable future. On
the other hand, if the request is approved, the Association will have to be
prepared to move on relatively short notice. I bring this issue to your attention
so that the membership, particularly our thoughtful members who spearheaded
the construction of the Kelly Memorial Building in the fifties, will understand
why your officers may be scurrying about with designs for a new facility.

Philip Cogan,

PRESIDENT

FEBRUARY, 1982

The Centennial Committee

David Stewart

MARYLAND
PHARMACEUTICAL
ASSOCIATION

First Professor of Pharmacy
in America

by Ben Allen, Ph.D.

The Maryland College of Pharmacy was organized
as a membership institution in the city of Baltimore. The
initiatory conference in forming the College was held in
the residence of Dr. Samuel G. Baker on June 8, 1840.
The group attending included three prominent physi-
cians (Baker was one) representing the Medical and
Chirurgical Faculty of Maryland and eight apothecaries
(David Stewart was one). After a lengthy discussion,
the meeting finally decided to appoint a committee of
five apothecaries (David Stewart, Secretary) to devise a
plan for the formation of a College of Pharmacy.

On Monday evening, June 22, 1840, a meeting was
held at Dr. Baker’s residence and the Committee re-
ported in favor of the formation of a College of Phar-
macy in the City of Baltimore. At a general meeting of
all regularly-educated apothecaries of the City held on
July 6, 1840, Stewart made some appropriate remarks
regarding the propriety and usefulness of such an in-
stitution. Also, at this meeting a Committee was ap-
pointed to draft a Constitution and By-laws for the Col-
lege of Pharmacy (David Stewart was a member of this
Committee).

A Constitution and By-laws were adopted at a
meeting held on the evening of July 30, 1840, and the
Maryland College of Pharmacy was finally ushered into
existence. The meeting then proceeded to elect the first
officers of the College (David Stewart elected to the
three member Board of Examiners).

The act of incorporation for the College was passed
by the Maryland Legislature during the December 1840
session and David Stewart’s name appears as one of the
incorporators. !

The incorporators, seventeen in number, immedi-
ately organized and established a course of instruction
in Chemistry, Pharmacy and Materia Medica. It was
decided that lectures, for a while at least, should be
delivered by the various willing members of the College

4

in regular rotation. Seven having thus consented
(Stewart lectured on Chemistry), entered upon their
duties the first week in November, 1841, for a period of
six months. It was thus conducted until the close of the
session 1843 and 1844, when it was considered best to
have distinctive professors for each department.”

The first home of the new institution was a single
back-room (little office) of Thomas G. Mackenzie’s
drugstore, north-east corner of Baltimore and Gay
Streets, (where, even now, in passing I always give
slight courtesy.)+> The College functioned at this loca-
tion during the period 1840—44.

On April 19, 1844, the Faculty of Physic of the Uni-
versity of Maryland offered to furnish a room in the Uni-
versity Building free of charge for use by the Maryland
College of Pharmacy, and to advertise and include the
Pharmacy College in the regular course so that their
students may participate. All rights of the Maryland Col-
lege of Pharmacy to be the same and there is to be no
interference on the part of either College. The Univer-
sity offered the loan of apparatus for use at times when
it can be spared. (This informal proposition was made
by Professor Aikin.)® The Pharmacy College was re-
quested to lecture on the second part of Wood and Bache’s
Dispensatory under the head of ‘‘Preparations’’ so that
the Medical class may have the opportunity of attend-
ing lectures on practical Pharmacy. A committee of three
(Stewart a member) was appointed to confer with Pro-
fessor Aikin regarding the union of lectures in the two
institutions.

In view of the problem of obtaining lecturers from
the College membership (eight members delivered lec-
tures at the previous session), a three member com-
mittee (Stewart was one) suggested that someone be
appointed as Professor of Pharmacy. This was very
important because of the proposed arrangement with
the Medical University. The proposal was accepted,
and the arrangement was consummated on April 24,

THE MARYLAND PHARMACIST

1844. On this date, Dr. David Stewart, an eminent
Chemist and Pharmacist, who had taken the degree in
Medicine at the University of Maryland at the recent
commencement (March 1844)’, was unanimously elect-
ed to Professor of Practical Pharmacy. On April 30th,
the title was changed to the ‘Chair of Theory and Prac-
tice of Pharmacy’ and Stewart was notified of this
change. The Maryland College of Pharmacy thus has
the honor of being the first institution in the country
to establish an independent Chair of Pharmacy.*:?:!°
The lecturers of the Pharmacy College were delivered
at the University of Maryland in Chemical Hall of ‘‘Old
Main’ (now Davidge Hall).

Prior to this time, in the College of Pharmacy, the
subject of Pharmacy was taught by Medical Members
(Physicians) of the Faculty in conjunction with the
branch of Materia Medica or Chemistry. Also, a similar
situation existed in Medical schools where the title often
used was that of Professor of Materia Medica and
Pharmacy or Chemistry and Pharmacy.!!:!2

William E. A. Aikin, Dean Faculty of Physic Uni-
versity of Maryland was very active in making the ar-
rangement for the union of the two institutions.'!* He
also turned over to the Maryland College of Pharmacy
‘‘room 20°’ in the old privately-owned and operated
University at the northeast corner of Lombard and
Greene Streets, for its meetings and cabinet of speci-
mens. It is interesting to note that on two separate occa-
sions Aikin was described as a Professor of Chemistry
and Pharmacy (1837 and 1838).'4:!5

The Maryland College of Pharmacy was an Associ-
ation of practitioners in the drug trade who were eager
to conduct their activities on the basis of scientific
knowledge and professional ideals, as well as commer-
cial interests. David Stewart was extremely involved in
the affairs of the College from its beginning (1840) and
the records show payment of dues for a period of ten
years and also some additional money payments to the
College. He helped to complete the negotiations be-
tween the Pharmacy College and the Medical group of
the University of Maryland for the delivery of Phar-
macy lectures in Chemical Hall of the old Medical
Building (now Davidge Hall).

David Stewart's interest in Pharmacy is illustrated
by the following College activities.'®

1841—Member of following Committees: Report on
Pharmaceutical articles to be presented at meetings,
prepare a list of prices to govern members of the Col-
lege, analyze articles for the benefit of College mem-
bers.

1842—Lecturer, Board Examiner for commence-
ment, member of Committee ‘‘State of the funds of the
College,’ arranged for public lecture and presentation
of diplomas (first commencement, Thursday evening,
June 9th at 8 o'clock), proposed improving some for-
mulae in the new United States Pharmacopeia, member
of Committee that drafted resolution on death of Col-
lege member Thomas E. Brennan.

FEBRUARY, 1982

1843—re-elected member Board of Examiners, re-
marked on mercurial preparations and suggested a new
formula (and procedure for compounding) for *‘mercury
with chalk’’ (to improve the one in the United States
Pharmacopeia), commented on blistering ointment and
spanish flies, delivered an essay on cyanogen and its
compounds and spoke against the use of cyanide of
potassium as a remedial agent, stated that it was time
(September) some arrangements were made for the
lecurers for the ensuing winter and proposed a plan,
however, a Committee of three was appointed (Stewart
a member) to take the whole subject into consideration,
he reported (October) for the Committee that the lec-
tures during the Winter will be every Tuesday evening
at 8 o’clock and each member of the College in order of
his name shall lecture from the English Edition of
Pereira’s Materia Medica® for thirty minutes (or other
authors upon subjects in order or give his own views on
the subject) followed by a question and answer period.

1844—offered a resolution to increase the college
membership fees, first time Stewart was referred to as
Doctor (April 19th), elected second Vice-President of
the College (January 30th), suggested the procurement
of a suitable case for specimens and other apparatus
(approved).

1845—Member of Committee appointed to investi-
gate proposed new formulas by College members (and
United States Pharmacopeia formulas), proposed (Oc-
tober 21st) a ten dollar fee for his course of lectures on
Pharmacy which also entitled the student to attend Dr.
Aikin’s lectures on Chemistry, member of Committee to
establish a Library, requested Board of Trustees to ap-
propriate sufficient funds for the purchase of suitable
books.

1846—Remarked on an essay delivered by a College
member on narcotic extracts, Committee member to
examine Pharmacopeia for revision at the National
Convention in 1850, gave notice (March 31st) that he
intended to resign as Professor, spoke on the prepara-
tion of ammonium phosphate, on motion of Mr. Mac-
kenzie, the resignation of Dr. Stewart was asked for
(April 28th) and Stewart resigned informally which was
accepted, elected Secretary of the College (December
29th).

1847—Proposed a plan by which the college should
appoint a standing committee for the examination of
drugs and chemicals whose genuineness or purity was
disputed (Stewart appointed member of this commit-
tee), appointed to new committee known as ‘‘Commit-
tee on Analysis,’ member of committee that reviewed a
communication from the College of Pharmacy in New
York (about this time, the New York City group was
interested in a law requiring the observance of certain
standards for imported drugs and chemicals!’), re-
elected Secretary of the College, Committee (Stewart

member) reported on the importation of spurious drugs.

“Jonathan Pereira, M.D. of London, a distinguished Phar-
macologist of his age. His death reported in the ‘‘Proceedings of the
American Pharmaceutical Association’’, Boston (1853), p. 19.

David Stewart (1813—1899) was born in Port Penn,
Delaware and educated at the New Castle Academy
(Delaware). At about the age of eighteen, he was sent to
Baltimore to study Pharmacy and Chemistry.'® David
Stewart and his brother James Van Dyke established in
1834 a drug store on the southeast corner of Hanover
and Camden streets. At the time, it was the only store
south of Baltimore Street in this section of the City.'??°
David Stewart opened a second store on Charles Street
north of Lexington Street (1839). Charles Street at this
time being built up near the Washington Monument and
many of Stewart’s customers lived in this section (the
customers previously patronized drugstores on Balti-
more Street).

In 1841, a Baltimore City directory listed David
Stewart, Druggist, Southeast corner Hanover and Cam-
den Streets. He was also in 1842 the preceptor for Fred-
erick A. Cochrane, one of the first three graduates
from the Maryland College of Pharmacy.?! (It is difficult
to imagine that this area, Hanover and Camden streets,
was a residential neighborhood with large town houses.
Today, on the northwest corner of Pratt and Sharp
streets still stands the house, somewhat modified for a
commercial use, and purchased in 1821 by Moses Shep-
pard. Upon his death he left money for the establish-
ment of a mental hospital, later known as Sheppard-
Pratt. Mr. Sheppard occupied the house for thirty-six
years and was visited by presidents of banks, railroads
and other businesses. Today, the Stewart drug store site
is occupied by the Baltimore Convention Center.)

Stewart and his brother dissolved the partnership
and after selling his second store (about or after 1844) to
College member Rufus T. Littlefield, he practiced
medicine in the City for some years, but made no suc-
CESS. OF it-2>

David Stewart was very active in civil affairs during
the early years and his political career was no doubt
advanced by his marriage (at the age of twenty-two) toa
daughter of an Eastern Shore Judge. He served as a
member of the Baltimore City Council (1835-37),
School Commissioner of Baltimore (1836), Ruling Elder
of the First Presbyterian Church (1838), and member of
the State Senate (1840).?4

In 1851, Pharmaceutists and druggists met in the city
of New York to discuss ways of assuring the quality of
imported drugs and the need for a national phar-
maceutical association. At this convention (the first of
the kind ever assembled in the United States) a letter
from Dr. Stewart was read giving his views in regard to
the subject of ‘‘Legal Standards for Drugs.’’ (David
Stewart was Inspector of Drugs, Port of Baltimore,
1S590=533)*77°

Dr. Stewart continued his interest in Pharmacy for
many years after receiving his medical degree. He was
one of two delegates from the Maryland College of
Pharmacy” at the National Pharmaceutical Conven-
tion (1852) held in Philadelphia. He was very active

» Note: College inactive at this time.

at this meeting and participated in a debate on *‘Good
Drugs, etc.’’ Also, Stewart was appointed to the Busi-
ness Committee, as well as, the Committee on the In-
spection of Drugs. At this time, he was the first to offi-
cially use the title ‘‘The American Pharmaceutical As-
sociation.’’ (He made a motion that this title be used in
Boson the following year.)’

At the Boston meeting of the American Phar-
maceutical Association in 1853, the name of David
Stewart appears on a Committee to prepare an address
to the Pharmaceutists of the United States on the sub-
ject of ‘‘Pharmaceutical Education.’’ However, he was
not in attendance at the meeting.?®

The report of the Committee on Education (Stewart
a member) was read and accepted at the Cincinnati
meeting in 1854. Also, at this meeting, Dr. David
Stewart was selected to serve on a special committee to
judge essays.’? He was re-appointed the following year
to the Committee of Judges.*° This Committee re-
ported?! at the Annual Meeting held in the City of Bal-
timore (1856) in the Hall of the College of Dental
Surgery and Stewart’s name was missing from the re-
port. (Osborne states that Stewart never attended a
meeting after his brilliant participation in the founding
of the American Pharmaceutical Association.**)

Never one to be satisfied with a routine of narrow
interests, Dr. David Stewart busied himself in the Fall
of 1847 with three other Medical practitioners in found-
ing the Maryland Medical Institute, a preparatory
school of medicine established at the corner of Fayette
Street and Elbow Alley.**+4 He also was interested in
the Medical and Chirurgical Faculty of Maryland, and
presented the following reports:*> Chemistry and Phar-
macy (1847), Materia Medica and Pharmacy (1849), on
the Pharmacopeia (1853 and 1855).3° His other ‘*Fac-
ulty’’ activities included a committee to expel guilty
members for violation of rules regarding advertising,
endorsing various medications, treatments, etc. (1848),
member of the Library Board (1849), reported on the
systems of weights and measures being used and urged
the adoption, etc. of the Metric System (1855).

It is interesting to note that in 1853 the Baltimore
Pathological Society was founded by Dr. Stewart and
eight other Doctors.*7

In the July number, 1853, of the New York Journal
of Pharmacy, a formula was published of Dr. David
Stewart, for a preparation of Opium, intended as a sub-
stitute for Laudanum, and also as a substitute for the
nostrum known as McMunn’s Exlixir of Opium. (Stew-
art’s formula contained opium, lime, water, ammonium
chloride, and alcohol.)38

Dr. David Stewart accepted the professorship of
Chemistry and Natural Philosophy on the Faculty of
St. John’s College in Annapolis (1855—62) and at the
same time was acting as Chemist to the State Agri-

© The approximate location of this institution was on Sharp Street
near Baltimore; later this site was occupied by the Hopkins Place
Savings Bank (No. 7 Hopkins Place) across the street from the Civic
Center near the present Federal Building in Hopkins Plaza.

THE MARYLAND PHARMACIST

cultural Society. Also, at one time he was acting Pres-
ident of the College.*’

At the annual session of the Medical and Chirurgical
Faculty of Maryland, held June 1, 1856, the following
motion, offered by Dr. F. E. B. Hintze, was adopted:
‘That this Faculty highly approve of the reorganization
of the Maryland College of Pharmacy, and bespeak for
its judicious code of ethics the cordial support of the
legitimate members of the Medical profession.’’4° In
1858, the Pharmacy College rented from the Medical
and Chirurgical Faculty apartments on the second floor
of its new building at 47 North Calvert Street, second
door south of Saratoga‘! (this new ‘‘Hall,’’ first posses-
sion by the *‘Faculty”’ of its own building). In addition
to the advantages of comfortable meeting and lecture
rooms, the Pharmacy College here became a neighbor
of several Medical societies.**

The College of Pharmacy continued to occupy the
Hall of the Medical and Chirurgical Faculty until the
close of 1867, when the sale by the ‘‘Faculty”’ of its
Calvert Street property necessitated a removal to a
building at No. 12 West Baltimore Street, a few doors
west of the bridge (over Jones Falls), on the north
SIdG san

The minutes of the Maryland College of Pharmacy
of February 5, 1857 records the purchase of chemical
apparatus by Professor Stewart for use by the Pharmacy
College and that he was to be repaid for this purchase.
About this time, Stewart was invited by the College to
the commencement on March 6th to be held in Masonic
Hall (Corner of St. Paul Street and Court House
Lane).*5 In 1858, the Maryland College of Pharmacy
listed Professor David Stewart as an honorary member
of the College. At this time, Professor William Procter,
Jr. of Philadelphia, the so-called ‘‘Father of American
Pharmacy’’ was also listed as Honorary Member.*°

David Stewart returned to Port Penn, Delaware in
1862 and lived the life of a gentleman.*”? On January 12,
1871, the Maryland College of Pharmacy conferred the
Doctor of Pharmacy degree on David Stewart and Wil-
lameerocterait..>

Dr. Stewart died at Port Penn on September 2, 1899,
age 86.*°

REFERENCES

1. Journal of the Maryland College of Pharmacy, 1841—47
(Minute-Book).

2. Annual Catalogue of the Maryland College of Pharmacy, Session
of 1891—92, p. 11.

3. David M. R. Culbreth, ‘‘Reminiscences of Early Pharmacy in
Baltimore,’ J. Amer. Pharm. Assoc., 19(1930) 285.

4. Address by David M. R. Culbreth, Maryland Pharmacist,
5 (1929-30) 506.

5. Eugene F. Cordell, **University of Maryland, Volume 1,’ The
Lewis Publishing Company, New York-Chicago, 1907, p. 412.

6. Reference 1.

7. University of Maryland Catalogue, 1844.

8. Reference 1.

9. Reference 5, pp. 415—416.

0. Eugene F. Cordell, ‘‘Medical Annals of Maryland, 1799-1899,”
Baltimore, 1903, p. 698.

11. Charles H. LaWall, ‘‘Four Thousand Years of Pharmacy,” J. B.
Lippincott Co., Philadelphia, 1927, p. 490.

FEBRUARY, 1982

12. Edward Kremers and George Urdang, ‘History of Pharmacy”
2nd. Ed., J. B. Lippincott Co., Philadelphia, 1951, pp. 208, 283.

ise Reterence 1:

14. Bernard C. Steiner, *“‘History of Education in Maryland,”
Washington: Government Printing Office, 1894, P. 131.

15. The Sun, Baltimore, Friday Morning, June 22, 1928.

16. Reference 1.

17 Reference 12; p. 260.

18. George E. Osborne, ‘‘David Stewart, M.D., First American Pro-
fessor of Pharmacy,’ American Journal of Pharmaceutical Edu-
cation, Vol. 23, No. 2, Spring 1959, p. 219.

19. Address by Alpheus P. Sharp, “‘The Retail Drug Trade of Balti-
more Three Score Years Ago,’ Alumni News-Letter, Maryland
College of Pharmacy, No. 4, August 1900, p. 11.

20. Advertisement, Dispensing Chemists—J. V. D. Stewart and
Henry S. Reay, Annual Circular Maryland College of Pharmacy,
Session 1870—71, p. XV.

21. Journal and Transactions of the Maryland College of Pharmacy,
Vol. 1, No. 1, June 1858, p. 20.

22. The Sun Paper, Baltimore, March 21, 1968, p. B1.

23. Reference 19.

24. Reference 18.

25. Proceedings of the American Pharmaceutical Association,
1851—57 (Minutes of the Convention of Pharmaceutists and
Druggists, New York, 1851, pp. 3—4.)

26. Reference 18, p. 223.

27. Proceedings of the American Pharmaceutical Association,
1851—57, (National Pharmaceutical Convention, Hall of the
Philadelphia College of Pharmacy, 1852, pp. 5—6, 11, 15—18, 20.)

28. Proceedings of the American Pharmaceutical Association, Bos-
ton, 1853, pp. 15, 47—48.

29. Ibid., Cincinnati, 1854, pp. 6, 10, 40.

30. Ibid., New York, 1855, p. 14.

31. Ibid., Baltimore, 1856, p. 19.

32) Reference) (85) pi 225.

33. Reference 26.

34. Reference 5, pp. 220, 233.

35, arenes 10), jos 1S, ik, PS, iat

AY, Moyle, foe, AAD 1122, i135}.

37! MiloyGl. fo. TADB.

38. Reference 31, p. 74.

39. Reference 18, p. 226.

40. Reference 5, p. 417.

41. Ibid., p. 419.

42. Reference 10, p. 705.

43. Reference 21.

44. Reference 5, p. 424.

45. Paul F. Norton, ‘““The Architect of Calverton,’’ Maryland His-
torical Magazine, Vol 76, no. 2, Summer 1981, p. 118.

46. Reference 21.

47. Reference 18, p. 227.

48. Minutes of the Maryland College of Pharmacy (1856-72).

49. Reference 10, p. 732.

calendar

Feb. 14 (Sunday)—BMPA Dinner Dance, Blue Crest

Mar. 8-1I—NARD Legislative Conference, Wash-
ington

Mar. 14 (Sunday)—Alumni Association Dinner
Meeting—Johnie Walker, Speaker

April 24-29—APhA Convention, Las Vegas

June 18-20—Maryland Society Hospital Pharmacist
Seminar, Williamsburg

June 20-24—MPhA Centennial Convention, Ocean

City

Industry Relations Committee

OTC Reformulations

The Question

Dear Sir,

The Maryland Pharmaceutical Association is the
statewide professional society of Pharmacists. The In-
dustry Relations Committee of the Association is the
body charged with ombudsman responsibility in the in-
teractions between pharmacists and manufacturing
interests. It is made up of both pharmacists and man-
ufacturing representatives.

Recently the Committee examined the increasing
number of OTC products that are being reformulated
and is seeking information from specific companies on
this matter. We are aware of the Proprietary Associa-
tion’s guidelines regarding the ‘‘flagging’’ of reformu-
lated products. However, the Committee would ap-
preciate your specific response to the following ques-
tions:

1. What OTC products from your company have
undergone reformulation in the past four years?

. What were the ingredient changes for each of
these products? (old-new)

. What were the reasons that these products were

~ reformulated?

. Do you anticipate that any of your products will
be reformulated in the future? If so, please list
them with expected changes and date of change.

. What is your company’s general policy with re-
gard to ‘‘flagging’’ reformulated products for the
information of the pharmacist and consumer?

It is the Committee’s intention to compile and
analyze this information, and eventually publish it for
the information of Maryland Pharmacists. We sincerely
appreciate your assistance with this important Com-
mittee project. Please advise me whenever the Associa-
tion or the Industry Relations Committee may be of
some assistance.

Sincerely,
David A. Banta
Executive Director

The Answers
Dear Mr. Banta:

This is in response to the questions pertaining to our
OTC products in your letter of May 1, 1981. The fol-
lowing response pertains to Schering labeled OTC
products.

8

Q.1. What OTC products from your company have
undergone reformulation in the past four years?

—None
Q.4. Do you anticipate that any of your products

will be reformulated in the future? If so, please list them
with expected changes and date of change.

OLD NEW

DEMAZIN Repetabs Tablets

Chlorpheniramine Maleate (CTM) 4.0 mg. 4.0 mg.

Phenylpropanolamine Hcl (PPA) 0 25.0 mg.

Phenylephrine Hcl (PE) 20.0 mg. 0
DEMAZIN Syrup (per 5 ml.)

CTM 1.0 mg. 2.0 mg.

PPA 0 12.5 mg.

PE 2.5 mg. 0

The changes are planned to reformulate accord-
ing to proposed Federal guidelines, and will take
place later in 1981 once approved by the U.S.
FDA (application is under FDA review).

Q.5. What is your company’s general policy with
regard to ‘‘flagging’’ reformulated products for the in-
formation of the pharmacist and consumer?

— Company policy requires that reformulation of
active ingredients in Rx and OTC products be
‘‘flagged’’ for the benefit of MD, Pharmacist,
and consumer customers.

With regard to the EMKO® line of products,
please direct your inquiry to:

Mr. Charles Salivar

Director of Operations

EMKO Products

c/o Schering Corporation

411 E. Gano Avenue

St. Louis, Mo. 63147
Yours truly,
Harold J. Fazio
Manager, Research &
Regulatory Liaison
Schering Corp.

Dear Mr. Banta:

In your letter of May 4, 1981 you inquired as to the
nature and extent of Warner-Lambert Company’s re-
formulation of OTC products over the past four years.

Let me begin by noting that this letter will address
only those OTC drub products marketed by the Con-
sumer Products Group of the Warner-Lambert Com-
pany. A copy of your letter has been forwarded to our

THE MARYLAND PHARMACIST

Parke-Davis Division in connection with those OTC
drug products which they market.

As an additional point of clarification, we assume
that by reformulation you are specifically addressing the
reformulation of active ingredients. To that issue, no
Warner-Lambert Consumer Products Group OTC drug
product has undergone active ingredient reformulation
in the past four years.

As you correctly noted, the Proprietary Association
does have guidelines regarding the ‘“‘flagging’’ of refor-
mulated products. Warner-Lambert Company, as an
active member of that association, of course, adheres to
those guidelines.

In terms of anticipated product changes, we regret
that our future plans must be regarded as confidential in
nature. You can, however, be assured that we maintain
a constant vigilance over our formulations, a vigilance
mandated by forever changing scientific, regulatory and
marketing requirements.

Thank you for your interest. If we can be of further
assistance, please feel free to let us know.

Sincerely,

John Purkert

Regulatory Affairs
Consumer Products Group
Warner Lambert

Déarsir:

Your letter of inquiry regarding changes in Bristol-
Myers Products formulas has been forwarded to my of-
fice for response.

Our policy has always been that our products’ for-
mulas, reasons for changes therein, and plans for, or
possibly future changes are confidential information
which we cannot release. We do provide current for-
mula information to regulatory and other governmental
agencies, and to compendial sources.

Bristol-Myers is a member of the Proprietary As-
sociation and subscribes to the P. A. ‘‘flagging’’
guidelines (May, 1977) published by that group. Exam-
ples of products which have been “‘flagged’’ for up to
six months after formula changes are EXCEDRIN,
EXCEDRIN PM and 4-WAY Cold Tablets.

Some of the kinds of information you desire will be
found by referencing several years of the annual Physi-
cians Desk Reference for Nonprescription Drugs.
Therein are listed many Bristol-Myers and other OTC
manufacturers’ products and their formulas.

Thank you very much for your interest in Bristol-
Myers.

Sincerely,
Ruth M. Palmes, M.D.
Bristol-Myers

Dear Mr. Banta:

In response to your recent letter we are pleased to
provide the following information about our product
line.

FEBRUARY, 1982

Over the years, there have been several Plough
products which have been reformulated, however, most
of these have involved changes in inactive ingredients
or minor adjustments of levels of active ingredients.

Formulation changes are made for a variety of rea-
sons, including availability of new ingredients which
improve the characteristics of the product, currently
used ingredients which may no longer be available, re-
placement of ingredients with actual or alleged concerns
of safety, or general reformulation to improve product
performance.

As with most OTC product manufacturers, we
anticipate reformulation may be required of several of
our products as a result of FDA’s on-going review of all
OTC products. However, specifics will not be known
until these monographs are finalized.

As an active member of the Proprietary Association,
we follow their ‘‘flag the label’ guidelines as described
in the attachment.

Thank you for this opportunity to provide informa-
tion to your association.

Sincerely,

Kenneth R. Johannes
Director Regulatory Affairs
Plough, Inc.

Dear Mr. Banta:
I am in receipt of your letter dated 1 May 1981 re-
questing information on reformulated OTC products.
During the past four years we have had few changes
in our proprietary products. The following products
have, however, had minor modifications:

Chloraseptic® (original menthol-green) yellow #5 (tar-
trazine) has been deleted from the liquid product.
NP-27 products formerly contained orthochloromer-
curiphenol or 8-hydroxy quinoline benzoate. All
products now contain either undecylic acid or zinc
undecylinate. These changes were made to provide
consistent formulation for the product line. In ad-
dition the fluorocarbons have been deleted from
NP-27 aerosol powder. A new aerosol system con-
taining hydrocarbons has been substituted.

Unguentine® fluorocarbons have been deleted from
the aerosol product. Hydrocarbons have been sub-
stituted as a propellant.

We do not anticipate any reformulation for other
OTC products at this time.

Our Company’s general policy in regard to ‘‘flag-
ging’ reformulated products is in agreement with the
PA policy on such information.

If I can be of any further assistance to you, please
feel free to contact me.

Sincerely,

Dennis B. Worthen, Ph.D.

Chief, Information Services

Norwich-Easton
Pharmaceuticals

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District Wholesale Drug Corp. :

7721 Polk Street ale,
mate al oie Ny 4 Spectro Industries, Inc.
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card tiny ama BE Jenkintown, PA. 19046
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Baltimore, MD 21237 (215) ee

(301) 485-8100

PARKE-DAVIS

Div of Warner-Lambert Co
Morris Plains, NJ 07950 USA

FOR ONE GOOD REASON
Oh ANOTHER

With Parke-Davis Generics there's every
reason to grow in the 80's. —

One good reason is our comprehensive line
of generics—a single source for most
generic needs.

Another good reason to grow with us is your
Parke-Davis Representative. This specially
trained expert knows your individual generic
needs and is ready to show you how fo profit
most from our broad line.

Then consider the unsurpassed quolity of
Parke-Davis Generics. Our generic products
are equal in quality to our brand name
products. And they're backed by the same
liability protection as well.

There are many more reasons to grow with
Parke-Davis Generics: the Cash Discount
Plan, General Products Purchase
Agreement...they add up to what we feel
is the best generic package in the

industry today.

c 1981 Warner-Lambert Company PD-220-JA-(173-P-1(1-81)

SpeaKINe P

YOUR PROFESSIONALISM DEMANDS OURS...

because Roche respects your knowledge. Our con-
tinuous training program is designed to help
Roche representatives be as professional in their
own right as you are in yours.

AT LEAST 750 HOURS OF TRAINING...

are concluded before any candidate becomes a
fully-qualified Roche representative. This exten-
sive preparation covers topics ranging from
pathology to pharmacology to facilitate discussion
of our products on a professional level.

FIELD CERTIFICATION...

by a Roche division manager is required of our
experienced representatives for all new products
and is a prerequisite for each new Roche represen-
tative. This important step develops person-to-
person communication techniques, so interaction
is never time-consuming and always informative.

ANNUAL REVALIDATION...

of each representative’s product and technical
knowledge is Roche policy. And it’s a good policy,
as it ensures that our people keep abreast of devel-
opments in this dynamic field.

ANSWERS TO YOUR QUESTIONS...

will reflect this extensive training each representa-
tive receives. Questions that involve more
detailed information get prompt attention from
Roche Professional Services.

)FESSIONALLY

A WIDE RANGE OF VALUABLE PROGRAMS AND POLICIES...

are available to you through Roche. If you are not familiar with any
program listed below, ask your Roche representative.

I Product Liability Guaranty 0 RETRIEVE—Roche Computerized
3 Liberal Return Goods Policy Information System

Roche Medical Emergency Line for 0 ROSPONSE—Product Information

Pharmacists and Physicians and Consultation
4. Drug Abuse Warm Line O Pharmacist Antibiotic
. Therapy Test (PATT)
: -o ae Disorders Therapy Test
5 eae: | Jarmacy Seminar Series

ing Education

Your Roche representative:
~ another example of the Roche pursuit of excellence

ROCHE LABORATORIES
Division of Hoffmann-La Roche Inc.
fi Nutley, New Jersey 07110

To keep drug product selection a workable
chase them.
The California Pharmacists Association
wrote to drug manufacturers and distributors, xe
asking them to provide new and updated in- ISC osu re
ufacture the final dosage form. On these =
pages is the latest information provided to the association.
We have added some drugs to the list because they are now available from a greater number of sources. All
information concerning the manufacturers of drug products applies only to those dosage forms and

concept, pharmacists need information about
the source of drug products before they pur- anu ac urer
formation on which companies actually man-
strengths distributed by the companies. The distributor appears on the left, the manufacturer on the right.

Acetaminophen with Codeine %, /2 and 1 gr tabs Parke-Davis - - — Parke-Davis
Barr Labs — — — — — — Barr Labs Parmed Pharm.- - - - - - - Biocraft Labs or Cord Labs
Burroughs Wellcome Co. - — Burroughs Wellcome Co. Penta Products— — - - — - - Barr Labs
H.R. Cenci Labs - - - - - - Cord Labs Philips Roxane —- - - - - - - Philips Roxane
Drummer Labs — - —- - - - - Lemmon Purepac — - - — — — Biocraft Labs or Cord Labs
Geneva Generics - - — - - — Cord Labs Rexall Drug Co. - — - - - - Barr Labs
Ladco Labs - —- ~----- Rugby Labs! Rugby Labs —- ~- - - - —- - - Chelsea Labs
Lederle Labs —- - - - - —- —- - KV Pharm. or Barr Labs Smith Kline & French — — — — Philips Roxane
Lemmon- - - ------- Lemmon Stayner Corp. - — - - - - - Barr Labs
McKesson Labs* - - — — - - Danbury Pharmacal E.R. Squibb & Sons—- — - - - E.R. Squibb & Sons
McNeil Pharm. - — - - - -— - McNeil Pharm. Vangard Labs* - - ~ - - - - Biocraft Labs
Parke-Davis - - - - - - - - Parke-Davis West-Ward* -— —- - -- - - - Cord Labs
Parmed Pharm.- -— — —- — - — Cord Labs Wolins Pharmacal* - — - - - Biocraft Labs
Penta Products— - —- — - - - Halsey Drug Co. or
Zenith Labs Amoxicillin 125 mg liquid and caps and 500 mg caps
Philips Roxane — - - - - - - Philips Roxane Beecham Labs — — - - —- - - Beecham Labs
Purepac - - - ------- Halsey Drug Co. Geneva Generics - - - - - - Biocraft Labs
Rugby Labs - - —- - - - - - Halsey Drug Co. Hoffman-La Roche - - - - - Hoffmann-La Roche
Smith Kline & French — — — — Philips Roxane Ladco Labs - - - - ---- Rugby Labs' or
Stayner Corp. - ------ Philips Roxane Biocraft Labs
Towne, Paulsen & Co.-— - — — Towne, Paulsen & Co. Parke-Davis —- - —- —- —- -- - John D. Copanos & Co.
Vangard Labs* — - — - - — — Heun/Norwood Labs Parmed Pharm.— — - - - - - Biocraft Labs or
West-Ward* - - - - - —- - - Halsey Drug Co. Mylan Pharm.
Wolins Pharmacal* — - - — - Blue Cross Products or Penta Products -— -— -— - - - - Biocraft Labs
Zenith Labs Rexall Drug Co. —- - - - - - Biocraft Labs
A.H. Robins Co. - — —- - — - Biocraft Labs
Allopurinol 100 mg, 300 mg Rugby Labs —- —- —- —- - - - —- Biocraft Labs
Boots Pharm) = ——]—— — — Generic Pharm. E.R. Squibb & Sons— - - - - E.R. Squibb & Sons
Burroughs Wellcome Co. —- — Burroughs Wellcome Co. Vangard Labs* - - - - - - - Biocraft Labs
Wolins Pharmacal* - — — — - Biocraft Labs
Aminophylline 100 and 200 mg tabs Wyeth Labs - - - - —- - - - Wyeth Labs
H.R. Cenci Labs - —- - - — - Richlyn Labs or Cord Labs
Coast Labs fee aa Cord Labs Ampicillin 125 and 250 mg liquid and 125, 250 and 500 mg
Geneva Generics - - - — - - Cord Labs caps
ION PRA Sioa ICN Pharm. H-RAGene] Cabs mee Biocraft Labs
Invenex Pharm.* - — — - - —- Invenex Pharm. Coast labs eee ee Mylan Pharm.
McKesson Labs* — - - - - - Richlyn Labs Geneva Generics - — - - — - Mylan Pharm., Biocraft Labs
Ladco Labs ~ - -—~---- Rugby Labs' or or Zenith Labs
Chelsea Labs ICN Phar eee Mylan Pharm.
Parmed Pharm.— — — — - - - Ormont Drug Cadco Cabs ee Rugby Labs!
Penta Products — — — -— - —- - Halsey Drug or Richlyn Labs or Biocraft Labs
PUSCD QC be eee Cord Labs Lederle Labs - - - - - - - - Mylan Pharm.
Rugby Labs =.— ===" i- Chelsea Labs McKesson Labs* — - - - - - Mylan Pharm.
Dearie. PAN lessee Peat Searle & Co. Parke-Davise 0 seen ee John D. Copanos & Co.
Stayner COND ys tee nae Cord Labs Parmed Pharm. — — - - - - - Biocraft Labs
Vangard Labs* - — - —- - - - Richlyn Labs or Mylan Pharm.
Wests al 0 ea tena West-Ward Penta Products === = Biocraft Labs
Wolins Pharmacal* - — — — — Richlyn Labs or Blue Cross Ptipnarmecs #0 Pfizer
Products Purepac = = — —— --——=— Purepac
Late e. Rexall Drug Co. - - - —- — — Biocraft Labs
Amitriptyline HCI 10, 25 and 50 mg tabs Rugby Uabsi2h= = — — = = = Mylan Pharm.
Bart Cabs = mn Barr Labs or Biocraft Labs
H.R. Cenci Labs - - - - ~ — M.D. Pharm. Smith Kline & French - — — — Bristol Labs
Coast Labs - - - - - ~~ — M.D. Pharm. E.R. Squibb & Sons - - - — - E.R. Squibb & Sons
Geneva Generics - - —- —- - — Cord Labs
pila Roche fete esi Seay Pecet bate * No response was received from this company. The information
Chaised bane listed has been taken from previous articles.
Lederle Labs - - - - - - - - Biocraft Labs 1 See the Rugby listing to determine the manufacturer of this
McKesson Labs® — — — — — — Barr Labs product.

14 THE MARYLAND PHARMACIST

Towne, Paulsen & Co.-— — — — International Labs, Penta Products Halsey Drug Co.
John D. Copanos & Co. Rugby Labs Marshall Pharm.
or Biocraft Labs or Chelsea Labs
Vangard Labs* Biocraft Labs Towne, Paulsen & Co.— ~ — — Towne, Paulsen & Co.
West-Ward* Zenith Labs Vangard Labs* Zenith Labs
Wolins Pharmacal* Biocraft Labs, West-Ward* West-Ward
Chromalloy Pharm., Mylan Wolins Pharmaca!* Drummer Labs
Pharm. or Zenith Labs
ci Labs ALR 3 Chloral Hydrate 500 mg caps
APC with Codeine ¥, Ya, /2 and 1 gr tabs Sela ue dele ae ceae es

Burroughs Wellcome Co. - — Burroughs Wellcome Co. Sah mv R.P. Scherer ma
H.R. Cenci Labs Zenith Labs eneva Generics R.P. Scherer Corp.

Geneva Generics Cord Labs ICN Pharm.” R.P. Scherer Corp.
: Invenex Pharm.” R.P. Scherer Corp.
ICN Pharm. ICN Pharm. ees toap 5 pate!
Lederle Labs Barr Labs adco Labs : nook aoe 3
Eli Lilly & Co. Eli Lilly & Co. or R.P. Scherer Corp.

* Lederle Labs R.P. Scherer Corp.
McKesson Labs Danbury Pharmacal .
Parke-Davis Gare Davie McKesson Labs R.P. Scherer Corp.

: Parke-Davis R.P. Scherer Corp.
oued: bfelin: Ze Eas Penta Products Chase Chemicals or Banner
or Danbury Pharmacal phifics*hoxa RP. Sch Cor
Penta Products Halsey Drug Co. Dataset sani Pee ete ie
Purepac — — R.P. Scherer Corp.
Pipetite Rugby Labs R.P. Scherer Cor
Rugby Labs Halsey Drug Co. iced on eae CORLS P:

Stayner Corp.

Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.

Vangard Labs*

West-Ward* Halsey Drug Co.

Wolins Pharmacal* Blue Cross Products
or Zenith Labs

Wyeth Labs Wyeth Labs

Cord Labs or Encapsulations

Smith Kline & French — — — — R.P. Scherer Corp.
E.R. Squibb & Sons .P. Scherer Corp.
Stayner Corp. .P. Scherer Corp.
Towne, Paulsen & Co.— — — — R.P. Scherer Corp.
Vangard Labs* .P. Scherer Corp.
West-Ward* .P. Scherer Corp.
Wolins Pharmacal* Banner, Gelaton,
R.P. Scherer Corp.
or Encapsulations
Wyeth Labs — ~ R.P. Scherer Corp.

Aspirin with Codeine Ye, Y%, /2 and 1 gr
Burroughs Wellcome Co. - — Burroughs Wellcome Co.
Geneva Generics Cord Labs
Ladco Labs Rugby Labs!
Parke-Davis Parke-Davis
Parmed Pharm. Cord Labs

or Halsey Drug Co.

Penta Products Zenith Labs
Rugby Labs Halsey Drug Co.
Stayner Corp. Cord Labs

Belladonna Alkaloids with Phenobarbital tabs
Beecham Labs Beecham Labs
H.R. Cenci Labs Richlyn Labs

or Drummer Labs

Coast Labs Cord Labs
Drummer Labs
Geneva Generics Cord Labs
Invenex Pharm.* Invenex Pharm. or Cord Labs
Lemmons = Lemmon
Parmed Pharm. Zenith Labs or Rondex Labs
Penta Products Halsey Drug Co.
Purepac Purepac
A.H. Robins - — A.H. Robins
Rugby Labs Drummer Labs
Stayner Corp. Rondex Labs
Towne, Paulsen & Co.— — ~ — Towne, Paulsen & Co.
Vangard Labs Drummer Labs
West-Ward’* West-Ward

Chlordiazepoxide HCI 5, 10 and 25 mg caps

Abbott Labs ~ Abbott Labs

Barr Labs _ - Barr Labs

H.R. Cenci Labs Western Research Labs

Geneva Generics — — - Cord Labs

Hoffmann-La Roche Roche Products

Lederle Labs Barr Labs
or Western Research Labs

McKesson Labs* McKesson Labs

Parke-Davis : Parke-Davis

Parmed Pharm. Cord Labs, Richlyn Labs
or Premo Pharm.

Penta Products - — — — — - Barr Labs

Philips Roxane Philips Roxane

Purepac — - Purepac

Rachelle Labs Rachelle Labs

Rexall Drug Co. Mylan Pharm.

Rugby Labs Chelsea Labs

Smith Kline & French Smith Kline & French

E.R. Squibb & Sons Mylan Pharm.

Stayner Corp. Barr Labs

Towne, Paulsen & Co. Western Research Labs

Vangard Labs" — - - Western Research Labs

West-Ward* West-Ward

Wolins Pharmacal* Cord Labs, Zenith Labs
Barr Labs or Mylan Pharm.

Bropheniramine Maleate with Decongestant elixir and expec-
torant

H.R. Cenci Labs H.R. Cenci Labs

Lederle Labs National Pharm.

Life Labs -— Life Labs

Penta Products — - - = Life Labs

A.H. Robins . == A.H. Robins
, Ladco Labs Rugby Labs', Mylan Pharm.
Rugby Labs : : - Bay Labs or National Pharm. or ake teat

Stayner Corp. se Bay Labs Lederle Labs - - Mylan Pharm.

Butabarbital 15, 30 and 50 mg tabs

Coast Labs - - ~- - - - Cord Labs . .
Drummer Labs - - - Lemmon * No response was received from this company. The information

Geneva Generics - — ~ - - Cord Labs listed has been taken from previous articles.

Invenex Pharm." - Invenex Pharm. .
McNeil Pharm. - - - McNeil Pharm. 1 See the Rugby listing to determine the manufacturer of this

Parmed Pharm. _ - Zenith Labs or Cord Labs product.

Chlorothiazide 250 and 500 mg tabs
H.R. Cenci Labs Bolar Pharm.
Coast Labs - - Mylan Pharm.
Geneva Generics Bolar Pharm. (250 mg)
Mylan Pharm. (500 mg)

FEBRUARY, 1982 15

McKesson Labs
Merck Sharp & Dohme
Parmed Pharm.

Purepac — -

Rugby Labs

Smith Kline & French — — —

E.R. Squibb & Sons
Stayner Corp.

Towne, Paulsen & Co.- — -—

Vangard Labs”
West-Ward*

Wolins Pharmacal*

Mylan Pharm.

Merck Sharp & Dohme
Bolar Pharm.

or Mylan Pharm.

Mylan Pharm.

Mylan Pharm.

Mylan Pharm.

Mylan Pharm.

Mylan Pharm.

Mylan Pharm.

Mylan Pharm.

Danbury Pharmacal (250 mg)
Mylan Pharm. (500 mg)
Mylan Pharm.

Chlorpheniramine Maleate 4 mg tabs

Barr Labs - =

H.R. Cenci Labs
Coast Labs

Drummer Labs
Geneva Generics
ICN Pharm.“

Invenex Pharm.*
Ladco Labs
Lederle Labs
McKesson Labs*
Parmed Pharm.

Penta Products
Philips Roxane
Purepac

Rugby Labs
Schering Corp.
Stayner Corp.

Barr Labs

Cord Labs

Cord Labs
Lemmon

Cord Labs

ICN Pharm.
Invenex Pharm.
Rugby Labs!
Generic Pharm.
Danbury Pharmacal
Zenith Labs

or Danbury Pharmacal
Barr Labs

Philips Roxane
Purepac

Chelsea Labs
Schering Corp.
Cord Labs

Towne, Paulsen & Co.- — — — Towne, Pauisen & Co.

Vangard Labs*
West-Ward*
Wolins Pharmacal*

Generic Pharm.
West-Ward
Tablicaps or Generic Pharm.

Chlorpheniramine Maleate with Phenylephrine liquid

H.R. Cenci Labs
Merrell Dow Pharm.
Rugby Labs
Schering Corp.

H.R. Cenci Labs
Merrell Dow Pharm.
National Pharm.
Schering Corp.

Chlorpromazine HCI 25 and 50 mg tabs

H.R. Cenci Labs
Geneva Generics
Ladco Labs

Lederle Labs
McKesson Labs”
Parke-Davis
Parmed Pharm.
Penta Products

Philips Roxane
Purepac
Rugby Labs

Stayner Corp.

Towne, Paulsen & Co.- - — -

Vangard Labs*

Western Research Labs
Cord Labs

Rugby Labs', Cord Labs
or Zenith Labs

Western Research Labs
Zenith Labs

Cord Labs

Zenith Labs or Cord Labs
Western Research Labs
or Zenith Labs

Cord Labs

Cord Labs

Cord Labs, Zenith Labs
or Chelsea Labs

Cord Labs

Western Research Labs
or Cord Labs

Western Research Labs

* No response was received from this company. The information
listed has been taken from previous articles.

1 See the Rugby listing to determine the manufacturer of this

product.

2 Pfizer reports that it holds the patent on this product and says,
“No other company has been licensed by Pfizer to manufacture,
sell or distribute these products.” Since other companies also
reported manufacturing or distributing this product we are
listing this information but make no representation as to the

legitimacy of any seller's claims.

16

West-Ward*
Wolins Pharmacal*

Ladco Labs

Parmed: Pharm... =e — =

Pfizer Labs
Rugby Labs

Abbott Labs
Barr Labs

H.R. Cenci Labs
Geneva Generics
Ladco Labs
Lederle Labs

Parmed Pharm

Penta Products
Rugby Labs

Towne, Paulsen & Co.
USV Labs

Colchicine 0.6 mg tabs

Abbott Labs
Barr Labs
H.R. Cenci Labs — ~

Geneva Generics — — — — — —

Eli Lilly & Co.
Ladco Labs

McKesson Labs* --
Parmed Pharm.

Penta Products
Purepaces

Rugby Labs

Towne, Paulsen & Co.
Vangard Labs*
West-Ward*

Wolins Pharmacal*

Ayerst Labs
H.R. Cenci Labs
Coast Labs
Geneva Generics

Ladco Labs
McKesson Labs*
Parmed Pharm.

Penta Products
Purepac

Rugby Labs
Stayner Corp.
Vangard Labs*
West-Ward*
Wolins Pharmacal’

Dexamethasone 0.75 mg tabs

Barr Labs
Coast Labs

Geneva Generics
McKesson Labs*
Merck Sharp & Dohme
Parmed Pharm.— - — -

Penta Products- - - -
Philips Roxane — —- - --
Purepac

Rowell Labs

Rugby Labs

Zenith Labs
Western Research Labs

Chlorpropamide2 100 and 250 mg tabs

Rugby Labs
Premo Pharm.
Pfizer Pharm.
Pharmadyne

Chlorthalidone 25, 50 and 100 mg tabs

Abbott Labs

_ — Barr Labs
—~ — — Bolar Pharm.

Cord Labs or Mylan Pharm.
Premo Pharm.

Mylan Pharm.

or Lederle Labs

Bolar Pharm.

or Premo Pharm.

Zenith Labs or Barr Labs

- Bolar Pharm.

or Mylan Pharm.
Bolar Pharm.
USV Labs

Abbott Labs

Barr Labs

Zenith Labs

Zenith Labs

Eli Lilly & Co.
Rugby Labs!

or Chelsea Labs
Danbury Pharmacal
Danbury Pharmacal
or Zenith Labs
Barr Labs

Purepac

Chelsea Labs
Generic Pharm.
Zenith Labs
West-Ward
Danbury Pharmacal,
Generic Pharm.

or Zenith Labs

Conjugated Estrogens 0.625, 1.25 and 2.5 mg tabs

Ayerst Labs

Cord Labs or Zenith Labs
Cord Labs

Cord Labs

ICN Pharm.

Cord Labs

Cord Labs, Heather

Drug Co. or ICN Sharm.
Zenith Labs

Cord Labs or ICN Pharm.
Cord Labs or Chelsea Labs
ICN Pharm.

ICN Pharm.

Cord Labs

ICN Pharm.

or Heather Drug Co.

Barr Labs

Cord Labs

Cord Labs

Cord Labs

Merck Sharp & Dohme
Danbury Pharmacal
or Cord Labs

Barr Labs

Philips Roxane
Cord Labs

Rowell Labs
Chelsea Labs

THE MARYLAND PHARMACIST

Smith Kline & French — — - — Philips Roxane
Stayner Corp. Cord Labs
Towne, Paulsen & Co.— — - — Towne, Paulsen & Co.
Vangard Labs* ICN Pharm.
West-Ward* Cord Labs
Wolins Pharmacal ICN Pharm.

or Heather Drug Co.

Dicloxacillin 250 and 500 mg caps
Beecham Labs Beecham Labs
Wyeth Labs Wyeth Labs

Dicyclomine 10 and 20 mg tabs or caps
Barr Labs Barr Labs
H.R. Cenci Labs Bolar Pharm.
Coast Labs Bolar Pharm.
Drummer Labs Lemmon
Geneva Generics Barr Labs
Lederle Labs Barr Labs
or Danbury Pharmacal
McKesson Labs* Danbury Pharmacal
Merrell Dow Pharm. Merrell Dow Pharm.
Parmed Pharm. Bolar Pharm.
or Danbury Pharmacal
Penta Products Barr Labs
Rugby Labs Chelsea Labs
| Stayner Corp. Generic Pharm.
, Towne, Paulsen & Co.— — — — Generic Pharm.
or Barr Labs
Vangard Labs* Generic Pharm.
Wolins Pharmacal* Tablicaps, Richlyn Labs
or Generic Pharm.

Diethylpropion HCI 25 mg, 75 mg tabs
Coast Labs M.D. Pharm.
Drummer Labs : Lemmon
Geneva Generics M.D. Pharm. (25 mg)
Riker Pharm. (75 mg)
Merrell Dow Pharm. Merrell Dow Pharm.
Parmed Pharm.
Purepac
Riker Labs Riker Labs
Rugby Labs M.D. Pharm.
or Chelsea Labs
Towne, Paulsen & Co.— — — — M.D. Pharm.

Diethylstilbestrol tabs
Eli Lilly & Co. Eli Lilly & Co.
Miles Pharm. Miles Pharm.
Penta Products Tablicaps
Rugby Labs Tablicaps

Digitoxin 0.1 and 0.2 mg tabs
Barr Labs Barr Labs
Invenex Pharm.* Invenex Pharm.
Eli Lilly & Co. Eli Lilly & Co.
McKesson Labs* Barr Labs
Parmed Pharm. Zenith Labs
Purepac Purepac
Rugby Labs Barr Labs or Purepac
Towne, Paulsen & Co.— — —- — Towne, Paulsen & Co.
Vangard Labs” Ketchum Labs
West-Ward* West-Ward
Wolins Pharmacal* Zenith Labs, Barr Labs

or Ketchum Labs

* No response was received from this company. The information
listed has been taken from previous articles.

1 See the Rugby listing to determine the manufacturer of this
proauct.

2 Pfizer reports that it holds the patent on this product and says,
“No other company has been licensed by Pfizer to manufacture,
sell or distribute these products.” Since other companies also
reported manufacturing or distributing this product we are
listing this information but make no representation as to the
legitimacy of any seller's claims.

FEBRUARY, 1982

Digoxin 0.25 mg tabs

Burroughs Wellcome Co.

Geneva Generics
McKesson Labs*
Parmed Pharm.
Penta Products
Purepac

Rugby Labs

— — Burroughs Wellcome Co.
Zenith Labs
Zenith Labs
Zenith Labs
Zenith Labs
Purepac
Halsey Drug Co.

Smith Kline & French — — - — Philips Roxane
Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.

Vangard Labs*
West-Ward*
Wolins Pharmacal*

Zenith Labs
West-Ward
Zenith Labs

Diphenhydramine Expectorant liquid

H.R. Cenci Labs
Geneva Generics
Lederle Labs

Life Labs — -

H.R. Cenci Labs
Bay Labs
National Pharm.
Life Labs

McKesson Labs*
Parke-Davis
Parmed Pharm.

Penta Products

MK Labs
Parke-Davis
National Pharm.
or Bay Labs
Life Labs

Purepac —
Rugby Labs

Stayner Corp.
Vangard Labs”
Wolins Pharmacal”

Purepac

Bay Labs, Clay Park Labs
or National Research

Bay Labs

National Pharm.

National Pharm., Generic
Pharm., Zenith Labs

or Chromalloy Pharm.

Diphenhydramine HCI 25 and 50 mg caps

Barr Labs

H.R. Cenci Labs
Drummer Labs
Geneva Generics
ICN Pharm.”
Invenex Pharm.
Ladco Labs

Lederle Labs — — — —

McKesson Labs*
Parke-Davis

Barr Labs
Cord Labs or Generic Pharm.

Cord Labs

ICN Pharm.

Invenex Pharm.
Rugby Labs!

or Chelsea Labs

Barr Labs

or Danbury Pharmacal
McKesson Labs
Parke-Davis

Parmed Pharm.

Penta Products

Philips Roxane
Purepac

Rugby Labs

Smith Kline & French —
Stayner Corp.

Towne, Paulsen & Co.-—
Vangard Labs”
West-Ward*

Wolins Pharmacal*

Danbury Pharmacal,

Barr Labs, Zenith Labs
or Cord Labs

Generic Pharm. or Barr Labs
Philips Roxane

Purepac

Chelsea Labs

Smith Kline & French
Generic Pharm.

Towne, Paulsen & Co.
Generic Pharm.
West-Ward

National Pharm., Generic
Pharm., Zenith Labs

or Chromalloy Pharm.

Diphenoxylate HCI 2.5 mg with Atropine Sulfate .025 mg

Barr Labs

Coast Labs
Geneva Generics
Lederle Labs
McKesson Labs*
Parmed Pharm.
Penta Products
Philips Roxane
Purepac

Rexall Drug Co.
Rugby Labs
Searle Pharm.

Barr Labs

M.D. Pharm.
Cord Labs

Barr Labs or Mylan Pharm.
Barr Labs

Cord Labs

Barr Labs
Philips Roxane
Halsey Drug Co.
M.D. Pharm.
Chelsea Labs
Searle & Co.

Smith Kline & French — — — — Mylan Pharm.

Stayner Corp. -— —- - - -

— — Philips Roxane

Continued in March Issue

LZ

18

Dog work: counting inventory, filing, Keeping up-to-date price lists: that’s not what we
went to school for. But it takes up too many hours in a pharmacist’s day. Bob Bergstein
and Jon Johnson of the Clinton Pharmacy, Clinton, MD, found the answer in the IBM QS/1
System.

Jon Johnson says, ‘Our Medicaid volume runs in excess of $10,000 per month, and the
turn-around time from submission to cashing of the check has been cut from 34 to nine
days. Our Aetna payments are now paid within days against the old system which took
almost two months. At 2% a month, the interest on that money alone almost justifies the
cost of the machine.”’

Bob Bergstein concurs. “The QS/1 posts charges and third party plans automatically;
prices prescriptions; prints labels — it takes only three seconds to print a refill label,’ Bob
notes.

Call Jon Johnson or Bob Bergstein at the Clinton Pharmacy, (301) 868-2000.
They'll give you a free demonstration of the QS/1 on the job. It’s easy to lease. Now’s the
time.

Credential Computer Associates
P.O. Box 1967 - 2525 N. Seventh Street, Harrisburg, Pennsylvania 17105

THE MARYLAND PHARMACIST

SUCCESS BREEDS SUCCESS

First there was

Then came And then
e¢ #1 pharmacist-recommended @ The decongestant with antihista- SYRUP
cold tablets: ine really sell Cate
pike ecet es .thanksto your ll the best of Sudafed with dex-
@ More than 401,200,000 tablets tromethorphan and guaifenesin has
sold last year. . . and growing ata e 55% was purchased because made this a real buy for customers of
rate faster than the market’ pharmacists recommended it? Sudafed. . . thanks again to

pharmacists’ recommendations

e 34% of sales are attributable to
physicians’ recommendations’

~
aw or

chr AG

The newest
Sudafed profit maker

SUDAFED S.A.

@ The sustained action capsule that
will open your customers’ nasal
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e 120 mg capsules available in
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Display the winners...display the
fine family of SUDAFED products to generate
customer loyalty and PROFITS for you

References: |. Open Call Survey, Am Drug heat BU oudie eu come co
gist, Sept. 1981. 2. Data on file, Burroughs Research Triangle Park
Wellcome Co Wellcome | North Carolina 27709

University of Michigan University of Wyoming University of Wisconsin-Madison _ Ferris State College

Remember
| |
the summer of ’817
Last summer, four young people joined The
Upjohn Company as part of the NPC Pharmacy
Internship Program.

They added to their educational process...
learned about manufacturing, quality control,
pharmaceutical research, and marketing/sales.

We hope we answered their questions. Cer-
tainly, we took their suggestions to heart.

And when the 10 weeks were over, we parted
knowing that we'll enjoy seeing each other in

the years ahead.
And reminiscing about the summer of ’81.

© 1981, The Upjohn Company, Kalamazoo, Michigan 49001

‘B howe magaynes, faprtaek books
et) Gud tome broek W dee td

agatn ee oe gaa eek yy

That’s the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, Chances are your operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

FEBRUARY, 1982 21

SANDOZ
LISTENS...

TO SERVE
YOU BETTER.

OUR RETURNED
GOODS POLICY IS
ONE OF THE BEST.

AND WE’RE
COMPUTERIZED TO
GIVE YOU THE
FASTEST POSSIBLE
SERVICE.

It’s another example of our
response to your comments
and suggestions.

SANDOZ PHARMACEUTICALS
EAST HANOVER, NJ 07936 SANDOZ

© 1981 Sandoz, Inc. $DzZ 0-601

bdo
bdo

Maryland Poison
Prevention Week
March 21-27, 1982*

Jacquelyn S. Lucy, M.A., M.Ed.
Coordinator, Education/Communications
Maryland Poison Center

According to the Division of Poison Control, the
third week in March is March 21—27, 1982 so Maryland
Poison Prevention Week (MPPW-’82) has been changed
to coincide with the national observance.

As was mentioned in last month’s Maryland Phar-
macist, the Maryland Poison Center (MPC) is again en-
couraging pharmacists to become actively involved in
MPPW-82. Activities, such as increased promotion of
Syrup of Ipecac, conducting community poison pre-
vention programs, sponsoring poison prevention poster
contests, serve as excellent reminders to the public of
their pharmacist’s concern for safety.

Since MPPW-82 will focus on the need to treat all
medicines as potential poisons, it will encourage such
behaviors as proper storage, discarding old or outdated
medicines, use of safety closures by parents of small
children, etc. Since a common misconception exists
that over-the-counter drugs are not harmful except in
massive overdose, many people do not apply common
safety precautions when using or storing these items.
Non-prescription medicines, such as vitamins, have
even been used by parents as ‘“‘rewards’’ for positive
behavior.

The MPC recognizes the pharmacist as the best
source of consumer drug information. Therefore, as
part of our public education program, we advise the
public to consult their pharmacist when they have
questions pertaining to proper storage and usage of
medicines, their common side effects, as well as to the
proper selection of OTC drugs.

If you are a preceptor, MPPW-82 offers an excellent
opportunity for involving your student in this drug in-
formation and poison prevention role.

Obviously, all poison-related exposures or inquiries
should be referred to the MPC. In 1981, the MPC staff
handled over 47,000 poison-realted calls. Since we usu-
ally have a single pharmacist or pharmacy student on
duty, we are unable to handle referrals concerning gen-
eral drug information. Also, during MPPW, we will be
stressing that the Maryland Poison Center is a specialty
medical unit designed to deal specifically with poisons
and poisonings and is no? a general health hotline. Your
continued support in “‘spreading the word’’ will be
gratefully appreciated.

If you have any questions or comments about
MPPW-82, please contact me at (301) 528-7184.

THE MARYLAND PHARMACIST

As part of the Centennial Celebration, the Association is expand- Several recent groups of grade school students have toured the B.
/ ing exposure of the Kelly Memorial Building to public tours. Olive Cole Museum housed in the Kelly Building.

Samuel Lichter (left), Chairman of the Board, and Philip Cogan David Banta, Executive Director, holds an old prescription file

(right), President, are shown signing the special membership cer- which is part of the historic display found in the lower level of the
tificates which are being given to each member of the Association Kelly Building. SAPhA students are continuing the restoration of
during the 1982 celebration. Handsome mounting kits are avail- this section of the museum.

able from the Association (see page 31) so members might display
the certificate.

This page donated by
District-Paramount
Photo Service.

DISTRICT PHOTO ING

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
in Baltimore, 792-7740

FEBRUARY, 1982 23

Pictures courtesy Abe Bloom — District Photo

Perspectives in Pharmacy

Patient
Drug.

Information

Presented
in the interest of
better-informed
pharmacy

Neil L. Pruitt, R.Ph., President
National Association of
Retail Druggists

“The delivery of health care in our communities is
changing. Traditional institutions are giving way to home
health care and outpatient clinics. Handicapped persons with
their special needs for durable medical equipment and health
supports and appliances require personal attention. The
increase in over-the-counter products that were once
prescription-only means that
more customers will require
counseling on their use. An
increasing drug-dependent elderly
population will rely more than
ever on the professional advice of
their pharmacists.

“Patient counseling will
become more important than ever
before because of the hosts of
different populations we are seeing
in our stores— the handicapped,
the elderly, the teenager who has
more money to spend on
cosmetics, the consumer who
wants to know about the efficacy of the drugs he or she
is taking.

Neil L. Pruitt, R.Ph

“Talking to our Customers gives us a unique marketing
advantage because we know who they are and what they
want. Service is, indeed, one of our keys for survival.”

Dorothy L. Smith, Pharm.D.
Director of Clinical Affairs
American Pharmaceutical Association

“The pharmacist has an excellent opportunity to test the
patient's recall of the information provided by the physician,
to make the prescription instructions readily understandable,
and to reinforce the patient's faith in the prescribed therapy.

Part of a continuing series on today’s pharmacy

“The type and amount of
information required will vary
with the specific needs of the
patient. But generally, patients
want enough information to help
them complete the therapy as
easily and as safely as possible.

“Almost all patients will have
questions about applying the
drug regimen to their own
schedules. They are willing to
modify their daily activities to
accommodate a dosage schedule
if they understand why the
changes are best for them. But these questions can be
answered only on an individual basis.

“Handing the patient a full disclosure sheet does not
effectively help ‘educate.’ In fact, a long list of potential
adverse effects may even convince a patient not to take
the medication.

“Every effort must be made not to frighten the patient.
Basically, the role of the pharmacist is to help a patient use
drugs most effectively and with the least anxiety.”

Dorothy L. Smith, Pharm.D.

Reprinted from American Pharmacy, Vol. NS 21, No. 7, p. 382.

John F. Schlegel, Pharm.D., M.S.
Executive Director
American Association of Colleges of Pharmacy

“Most pharmacy professionals
recognize the importance of
communication skills. Indeed,
depending on one’s particular
perspective, personal pharmacy
service that emphasizes patient
education can be a source of
immense satisfaction, enhanced
professional image, increased
patronage, and improved health
care through better under-
standing and use of medicines.

“Influences both inside and
outside the profession point
toward a resurgence of personal
contact between the pharmacist and the patient. The public’s
‘right to know’ cannot responsibly be denied. The problem
has been in finding time in the pharmacy student's busy
curriculum for proper communication skills training.

“For the past several years, colleges of pharmacy have
been increasing the quantity and quality of training in this
area, and greater attention is being paid to the influence of
personality types on professional motivation.

“In the future, the 1980's will likely be described as the
‘Communications Era’ in pharmacy. The profession has made
significant advances, but there is still a need for more
change.”

John F Schlegel, Pharm.D., M.S.

Lilly Eli Lilly and Company

Indianapolis, Indiana 46285

100902

The views expressed are the authors’ and not necessarily those
of Eli Lilly and Company.

© 1981, ELI LILLY AND COMPANY

When >

was the

last time

your
insurance
agent
gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville, Maryland 21208
’ 484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
PAUL FREIMAN & JOSEPH FREIMAN EVERY
YEAR! Usually for more than 20% of their |
premium.

PAUL & JOE are two of the many Maryland
pharmacists participating in the Mayer and
Steinberg/MPhA Workmen’s Compensation
Program—underwritten by American

‘Druggists’ Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS... °°.

_ call or write:

Your American Druggists’' Insurance Co. Representative -

=) AMERICAN
ONY. DRUGGCISTS’
INSURANCE

Please contact me. | am interested in receiving more
information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. O Call

OO Write

Some Dates Tax You
More Than Others

If the only two certainties are death and taxes then the new IRS inflated penalties for late payment of
taxes is certain to make life more difficult. Pharmacists who need to remind themselves or their accountants ~
of the important Share the Wealth with Uncle deadlines should post this chart for reference.

Taxes that are due four or more times during the year are identified by key letters which are explained below the
chart. Note that if a tax is due on a weekend or holiday the due date is advanced to the next business day, causing
some taxes due the last of a month to be payable early the next month.

JANUARY 1982 JUNE 1982
Wednesday January 6 FD(a) Thursday June 3 FD(a)
Monday January 18 FI Tuesday June 15 FD(b), SD, FC/P, FI |
Thursday January 21 Si State & Federal individual, partner-
ship, and corporation taxes due with
FEBRUARY 1982 interest if extension had been granted.
lp
Monday February 1 FQ, FU, SQ, SU, FD Moncey unc! :
Wednesday February 3 FD(a)
Tuesday February 16 FD(b), SD, JULY 1982
‘ © 99 F
Monday February 22 Sil Teed ae aine FD(a) .
MARCH 1982 Wednesday July 21 Sil |
Wednesday March 3 FD(a)
Monday March 15 FD(b), SD AUGUST 1982
Calendar year corporations must file Monday August 2 FQ, FU, SQ, SU, FD
income tax return or pay 50% of unpaid Wednesday August 4 FD(a) .
taxes and file for 3 months automatic Monday August 16 FD(b), SD
extension. Acrual basis corporations Monday August 23 ST

must declare accrued expenses by this
date (24% months after end of taxable

—

year) SEPTEMBER 1982
Monday March 21 ST Friday September 3 FD(a)
Wednesday September 15 FD(b), SD, FC/P, FI .
APRIL 1982 Tuesday September 21 ST (
Monday April 5 FD(a)
Thursday April 15 Federal and state income tax due or OCTOBER 1982
you must pay estimated amount due
Monday October 4 FD(a)

and file for 60 day extension. Interest

will be due on amount paid after Thursday October 21 ST |
April 15.
State corporation tax due. 60 day ex- NOVEMBER 1982 |
tension may be requested. MARIeeEN b
State personal income tax due. EON or FOU OOD
FC/P. FI Wednesday November 3 FD(a) |
Wednesday April 21 ST ee ea i EDD
Friday April 30 FQ, FU, SQ, SU, FD DEES N ENON ION G7: a
MAY 1982 DECEMBER 1982
Wednesday May 5 FD(a) Friday December 3 FD(a)
Monday May 17 FD(b), SD Wednesday December 15 FD(b), SD, FC/P .
Friday May 21 Se Tuesday December 21 Sil |
FD(a) Last payment due on Federal income and social security taxes withheld during the previous month if over $3000 was withheld. You are |

required to deposit the amount withheld within 3 banking days after you reach $3000 at the end of any eighth-monthly period (these
periods end on the 3rd, 7th, 11th, 15th, 19th, 22nd, 25th, and last day of the month)

FD(b) Federal income and social security taxes withheld must be deposited by this date if between $500 and $3000 was withheld during the ©
previous month.

|

FQ Federal Quarterly income and social security taxes withheld must be paid. ;
FU Federal Unemployment tax must be paid.
FC/P Federal estimated corporation and partnership taxes must be paid if on calendar basis (note—fiscal year corporations pay this tax on

Sth day of 4th, 6th, 9th, and 12th month of their year) |
FI Federal estimated individual tax for previous quarter due.
FD Federal social security and withholding tax if any due domestic workers.
Si Maryland State Sales Tax due.
SQ Maryland State income tax withheld due for previous quarter.
SU Maryland State Unemployment taxes due.

SD Maryland State estimate of income tax withheld the preceeding month must be deposited.

NOMINATIONS

The Awards Committee of the Maryland Pharmaceutical Association is soliciting nominations
from the membership for two prestigious awards which are presented to pharmacists at the Annual
Banquet. Since this is a special year due to the Centennial Celebration, the Committee decided that
more membership input into the Awards process would be appropriate. The two Awards are:

BOWL OF HYGEIA This award is presented annually through the cooperation of the A. H.
Robins Co. to a pharmacist who has compiled an impressive record in the area of community
service.

MPhA Achievement Award This recently instituted award is given to a pharmacist who is
distinguished in the area of contributions to the profession of Pharmacy.

Nominations for either of these two awards may be sent to the Awards Committee for consid-
eration. Nominations must be in writing and should outline the qualifications of the individual for
the award being considered. Nominations are kept on file each year and may be considered by the
Awards Committee in future years. Nominations or inquiries about the nominating process should
be sent to the M.Ph.A., 650 W. Lombard Street, Baltimore, Maryland 21201.

RESOLUTIONS

The Vice Speaker of the House of Delegates, Jim Terborg, also serves as Chairman of the
Association’s Resolutions Committee. The Committee will be meeting soon to consider issues and
resolutions for the Annual Convention of the Association, June 20—24, 1982 in Ocean City, Mary-
land. In order to allow for greater membership participation in the resolution process which forms
the basic policy making structure of the Association, the Committee is soliciting input from the
membership in the form of suggested resolutions or resolution topics. Resolutions may be sent to
the Association at this time with any background or supporting information necessary. They should
be sent to the M.Ph.A. Resolutions committee, 650 West Lombard St., Baltimore, Md. 21201.

FEBRUARY, 1982 at

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Quantity discounts and special reorder
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28 THE MARYLAND PHARMACIST

LETTERS

Dear Dave:

I do not know about the rest of Maryland Pharma-
cists but I am mad as hell at PAID prescriptions over
their recent announcement to third party administrators
that they have a mail-order prescription drug service
available to allegedly help them hold down prescription
drug costs.

I remember in the late 1960’s when these third par-
ties came out and begged pharmacists to participate in
their plans. Over the years they have prospered by sell-
ing OUR services to their customers. They have prof-
ited because we have agreed to go along with their
plans, often to our great harm.

Now PAID, which owes its very existence to com-
munity pharmacists, stabs us in the back by offering this
mail-order scheme to the world. All these years they
have claimed to be the friend of the pharmacist and only
in business to help us and the recipient receive quality
health care. This action on their part once again shows
that these people hold us in complete contempt.

I personally am going to reevaluate my participation
in their program. I can no longer continue to support an
organization which clearly intends to help put me out of
business through their own selfishness.

Sincerely,
Paul Zucker

Dear Mr. Cogan:

As Vice President of Pharmacy Operations for Rite
Aid Corporation, I would like to respond to your edito-
rial in the October, 1981 edition of the Maryland Phar-
macist. In your article you asked for input regarding the
desirability of Maryland enacting mandatory continuing
education legislation.

I wish to state that while I support the concept of
continuing education, I am strongly opposed to any
legislation which would mandate this process. I am op-
posed in that our company currently operates stores in
states which mandate continuing education and observe
no noticeable difference in the quality of pharmaceutical
care delivered by all pharmacists in those states where
it is not. What we have observed is the enactment of a
cumbersome and expensive set of procedures which are
a burden to all pharmacists.

Our company currently provides several types of
continuing education to its pharmacists on a voluntary
basis. In addition, many other forms of continuing edu-
cation are available from other sources throughout the
State of Maryland. Those pharmacists so inclined as to

FEBRUARY, 1982

pursue this additional knowledge have ample opportu-
nity to partake in continuing education programs.

I believe that those pharmacists not inclined to par-
ticipation in continuing education on a voluntary basis
will get little or nothing out of it under a mandatory
system. Instead pharmacists will be forced to expend
money and effort to ‘‘go through the motion”’ of fulfill-
ing yet another regulatory hurdle.

In addition I have reviewed many of the programs
currently offered in the states where continuing educa-
tion is mandated. I find that a great many of the pro-
grams offered have little or no applicability or value to
the typical community pharmacist.

In addition, the cost of these programs has steadily
risen in those states where continuing education is man-
dated. I must question whether or not the extra cost and
inconvenience imposed upon the typical community
pharmacist can be balanced against an equal or greater
improvement in his or her standard of practice.

It is my belief that because of the reasons stated
above, the typical community pharmacist in Maryland
should continue to support continuing education on a
voluntary basis only.

Thank you for giving me an opportunity to com-
ment on this matter and please feel free to contact me
should you wish to discuss this subject any further.

Very truly yours,

RITE AID CORPORATION
Alex Schamroth

Vice President

Pharmacy Operations

Dear Dave:

The Maryland Society of Hospital Pharmacists will
hold their 17th Annual Seminar in Williamsburg, Vir-
ginia on June 18, 19 & 20. For more information, please
contact Normand Pelissier, Chairperson Seminar
Committee, ‘C/O The Union Memorial Hospital, 201
East University Parkway, Baltimore, Maryland 21218.

Sincerely,
Andrew Glorioso
Publicity Chairman

“When I lose track of my
inventory, I lose track of my profits...
so | rely on The Drug House.”

ee ee eee

Te

i s

INTMENTS - 2

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y
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Our Direct Order Entry System cuts order time to a split second
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(215) 223-9000 (717) 236-9071 (302) 655-7401 (301) 866-4600 (814) 288-5702
Ed Helfrich Paul Hawbecker Ed McKenna Al Turner Neil Smith

© 1981, The Drug House, Inc

30 THE MARYLAND PHARMACIS:

Classified Ads

Classified ads are a complimentary
service for members.

FOR SALE:

VENDING MACHINES: (3) Like new. Hot food, hot drinks, and
cold drinks. Buy one or all. Must sacrifice. Call Harold, Fen-
wick Apothecary, 433-1140.

PHARMACY w/LIQUOR LICENSE: Attractive, profitable, and
growing in Bel Air shopping center. Call Wayne Millner, Merrill
Lynch Realty/Commerical Services Division, 647-5830.

CENTENNIAL MARKET

“Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

*Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

* The M.Ph.A. is offering to the public and its members
the USP publication, ‘“About your Medicine.’ This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available— ‘About your
High Blood Pressure Medicine’ —$3.00 each plus $1.00
postage and handling.

“The Pharmacy Art Print “Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

“Centennial Apothecary Jars with the Association's
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

FEBRUARY, 1982

' 9 at

ACTUAL SIZE

Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the “P.D.” designa-
tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white §
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
Maryland Pharmaceutical Assn.
650 W. Lombard St.
Baltimore, Md. 21201

We at SELBY DRUG COMPANY
attribute our rapid growth and success
to our ability to make changes. These
changes are.made rapidly, when and
where they are needed!!

4gthe SELBY DRUG management

team evaluates sources of supply twice
a year.

2

Maybe it’s time for you to evaluate
your present drug wholesaler.

For information on our Full Line pro-
gram, please call person-to-person collect
2tO!
Michael Rosenberg,-R.P.
Senior Vice President

SELBY DRUG COMPANY

633 Dowd Avenue
Elizabeth, NJ 07201
(201) 351-6700

31

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)

Cephalosporins: New ihe Generation

Antibiotics
— Gerald Herpel |
Maryland College of Pharmacy and the Doctor

of Pharmacy Degree
— B. F. Allen, Ph.D.

Third Party Reference Chart

Plan Now to Attend the Centennial Convention
June 20-24, 1982 Ocean City, Maryland

Watch for Details in the Mail

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 wee,

MARCH, 1982 VOL. 58 NO. 3

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor

CONTENTS ABRIAN BLOOM, Photographer

Officers and Board of Trustees
3. President’s Message — Philip H. Cogan 1981-82

Honorary President

JOHN C. KRANTZ, JR., Ph.D. — Gibson Island

4 Cephalosporins: New Third Generation

= ean; eee President
Beta-Lactamase Resistant Antibiotics PHILIP H. COGAN, P.D. — Laurel
— Gerald Herpel President-Elect

MILTON SAPPE, P.D. — Baltimore

Vice-President
12 Maryland College of Pharmacy and the Doctor IRVIN KAMENTZ, P.D. — Baltimore
of Pharmacy Degree — B. F. Allen, Ph.D. Treasurer
MELVIN RUBIN, P.D. — Baltimore

5 ‘ Executive Director
17 Third Party Committee Reference Chart DAVID BANTAM Ase Balumere

Executive Director Emeritus

TRUSTEES

28 Abstracts SAMUEL LICHTER, P.D. — Chairman
Randallstown

WILLIAM C. HILL, P.D. (1984)

Easton
DEPARTMENTS GEORGE C. VOXAKIS, P.D. (1984)
Baltimore
BARBARA BARRON, P.D. (1983) }
20 Letters to the Editor Rising Sun, Maryland
STANTON BROWN, P.D. (1982)
Silver Spring
14 Calendar RONALD SANFORD, P.D. (1982) |
Catonsville
3] Classified Ads DUDLEY DEMAREST, SAPhA (1982) )
Baltimore |

EX-OFFICIO MEMBER
WILLIAM J. KINNARD JR., Ph.D. — Baltimore

ADVERTISERS :
15 Credential Leasing 22 Mayer and Steinberg HOUSE OF DELEGATES
19 District Paramount Photo 24 Smith Kline and French Speaker
18 Eli Lilly and Co. 11 Upjohn MADELINE FEINBERG, P.D. — Kensington )
30. Loewy Drug Co. 23 Youngs Drug Products Vice Speaker |
10 Maryland News Distributing JAMES TERBORG, P.D. — Aberdeen

MARYLAND BOARD OF PHARMACY
Honorary President

Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN. P.D. — Salisbury |
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BERNARD B. LACHMAN, P.D. — Pikesville |
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
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Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201. PHYLLIS TRUMP Se ee
, B.A. — Baltimore

2 THE MARYLAND PHARMACIST

MARCH, 1982

President's Message

Continuing with our Centennial Theme, *‘Remembering Where We’ve
Been/Deciding Where We're Going’’, the upcoming Spring Regional Meeting
will give all Maryland Pharmacists a chance to influence the direction of the
Association. For those of you who are not aware, the Association has three
major business or policy formulating meetings each year. The first is the Spring
Regional, which will be held this year on March 28th at the MPhA Headquar-
ters, the Kelly Memorial Building in Baltimore. The second is the Annual
Convention, this year to be held in June at the Carousel Hotel in Ocean City.
And, the third is the Fall Regional, which will take place at a location to be
announced.

Decisions are made by the House of Delegates, but all members have the
opportunity to voice their opinions and participate in deliberations. The dele-
gates are selected by the local associations and other affiliated or recognized
organizations.

We sincerely hope that as many pharmacists as possible will attend the
Spring Regional meeting this year. In addition to the business session, the
Centennial Committee has planned a brief program. As part of our Centennial
Celebration, a plaque will be dedicated to commemorate two distinguished
Maryland pharmacists, who were pioneers in the profession, James Proctor and
David Stewart. We will have a short reception to welcome the dignitaries and
new members and encourage attendees to tour the Kelly Memorial Building and
the B. Olive Cole Pharmacy Museum. The remainder of the program will fea-
ture a forum to openly discuss issues relating to our future. A panel of current
leaders in Maryland’s pharmacy organizations will explore, with the attendees,
such issues as: should we or should we not support mandatory continuing
education as a requisite for relicensure; should there be a closer affiliation
arrangement among pharmacy organizations in the State?; should nurse prac-
titioners be allowed to prescribe drugs?; should pharmacists be allowed to
prescribe?; would the pharmacists support a curriculum for an advanced phar-
macy degree outside the traditional school hours; and, should third party
payors for prescriptions be regulated by the State Insurance Board? I’m sure
you can suggest many more issues. Please come to the Spring Regional Meeting
so that your views may be heard and you may help decide our future.

Plgan

Philip H. Cogan,

President

Cephalosporins: New Third
Generation Beta-Lactamase
Resistant Antibiotics

by Gerard Herpel

Cephalosporins are a growing class of antibiotics.
The new numbers of the class have an enhanced spec-
trum against previously resistant strains of bacteria.
They are considered to be a desirable class of antibiotics
since their toxicities are very low as compared with the
aminoglycosides and other antibiotics active against
gram-negative bacteria. Recently, there has been a need
for antibiotics which are not destroyed by betalacta-
mases produced by various resistant organisms.?°!4)!5

Beta-lactamases are enzymes produced by bacteria
capable of inactivating penicillins and cephalosporins.
These enzymes hydrolyze lhe beta-lactamase ring (Fig.
1) rendering the antibiotic inactive. However, the cor-
relation between antimicrobial resistance and beta-
lactamase production is not perfect. Some bacterial
strains that fail to hydrolyze the cephalosporins are still
resistant to them; and vice versa, some bacteria which
hydrolyze the cephalosporins are still killed by them
(Goodman & Gilman, p1152). Cephalosporins vary in
their susceptability to beta-lactamases. As will be dis-
cussed later, the new cephalosporins are more active
against beta-lactamase producing bacteria and present
new alternatives for use against resistant organisms.

The following paper will outline the first and second
generation of cephalosporins that are already on the
market and being used clinically, followed by a detailed
discussion of the third generation of cephalosporins.

I) First Generation (Beta-lactamase Sensitive)
A) Parenterals

There are four commercially available products in
this group: (1) Cephalothin (Keflin"), (2) Cephapirin
(Cefadyl®), (3) Cefazolin (Ancef®, Kefzol®), and
Cephaloridine (Loridine”).

Spectrum

These cephalosporins are active against 90% of the
following bacteria:

Gerald Herpel is a graduating Pharmacy student at the University
of Maryland Schooi of Pharmacy.

4

1) Staphylococcus aureus (penicillase producing)*
2) Staphylococcus species

3) Streptococcus species”

4) Escherichia coli

5) Proteus mirabilis

6) Klebsiella pneumoniae

These cephalosporins are less reliably active against
the following organisms and sensitivity tests must be
performed before their use:

1) Neisseria gonorrhea

2) Haemophilus influenzae
3) Salmonella

4) Shigella

They are inactive against the following bacteria:

1) Streptococcus faecalis

2) Pseudomonas aeruginosa

3) Enterobacter

4) Indole-positive proteus (i.e., Proteus vulgaris)
_5) Serratia marcescens

Side Effects

The side effects of these cephalosporins are few and
include; (1) Some cross allergenicity in patients allergic
to penicillins; (2) Cephalothin and Cephapirin cause
pain on injection and possible thrombophlebitis; (3)
Cephalothin has been shown to possibly increase the
nephro-toxicity of the aminoglycosides?*; and (4)
Cephaloridine has a high incidence of nephro-toxicity;
therefore, it is not recommended for general use.

B) Oral Medication
There are four available cephalosporins which are
stable to oral absorption: (1) Cephalexin (Keflex”), (2)
Cefaclor (Ceclor"), (3) Cefadroxil (Duricef"), and (4)
Cephradine (Anspor", Velosef").

“Cefazolin is more sensitive to penicillinase produced by
Staphylococci and is not active against 90% of these bacteria (G & G,
p. 1154).

" Except enterococci, i.e., S. Faecalis

THE MARYLAND PHARMACIST

Spectrum

All four of these oral cephalosporins are similar in
activity to cephalothin except that they have less activ-
ity against penicillinase-producing Staphylococci.
However, cefaclor is more active than the others
against gram-negative bacilli, (i.e., H. influezae, E. coli,
and Proteus mirabilis). It is especially useful in otitis
media and upper repiratory infections caused by these
organisms (G & G, p1156).

Side Effects

The side effects are minor. There is a high incidence
of GI distress and administration with food will de-
crease the absorption. Also, there is the possible cross
allergenicity with the penicillins.

II) Second Generation (Beta-lactamase Resistant)

The cephalosporins of this class have an increased
activity against gram-negative organisms due to a
greater stability to beta-lactamase produced by the
gram-negative organisms. These parenteral formu-
lations show a decreased activity against the gram-
positive organisms than the older cephalosporins but
can still be used in most situations where gram-positive
coverage is required. Cefamandole (Mandol"), Cefoxi-
tin (Mefoxin®) and Cefuroxime are the three drugs of
this class most commonly used.

Spectrum

The second generation cephalosporins are active
against:

1) Haemophilus influenzae

2) Enterobacter

3) Indole-positive Proteus (i.e., Proteus vulgaris)
4) Serratia marcescens

5) Bacteroides

6) Neisseria gonorrhea‘

7) Salmonella

COOH

B-lactamase

They are not as active against gram as the first gen-
eration cephalosporins positive organisms. Like the
first generation cephalosporins, they are inactive
against Pseudomonas and Streptococcal faecalis.

The use of these cephalosporins should be confined
to specific organisms in which high activity occurs. This
will reduce the chance of resistant strains forming.
Cefamandole is indicated for infections caused by En-
terobacter, Haemophilus influenzae, and Salmonella.
Cefoxitin is indicated in Bacteriodes infections, and
Cefuroxime is the cephalosporin of choice in Neisseria
gonorrhea and is almost as active as ampicillin.' None
of the cephalosporins will cross the meninges, even
when they are inflammed, in sufficient amounts to reli-
ably treat meningitis.

Side Effects

The side effects are those common to other cephalo-
sporins, such as allergic reactions and cross allergenic-
ity with the penicillins. Cefamandole and cefuroxime
have a low incidence of pain and phlebitis upon injec-
tion; but cefoxitin does cause pain and possible phlebitis
upon injection.

II}) Third Generation (Beta-lactamase resistant)

The third generation cephalosporins have an even
greater activity against beta-lactamase producing
gram-negative organisms. The most notable increase in
activity is against Pseudomonas aeruginosa. They are
not as active against gram positive organisms as the
older cephalosporins, but do have good activity against
penicillinase-producing and methicillin-resistant
Staphylococcus aureus (see table 1)"

“ Much better activity than cephalothin.

“Table 1 lists five of the new third generation cephalosporins and
their activity against various organisms. The minimum inhibitory con-
centration (mcg/ml) for each drug by which 50% and 90% of all strains
were inhibited is compiled, as well as the standard deviation (T""') and
ranges of MIC’s observed.

Figure 1

MARCH, 1982

wa

TABLE |

(CFT) (CPZ) (MOX)
Cefotaxime Cefoperazone Moxalactam
MIC (st dev) MIC (st dev) MIC (st dev)
(range) (range) (range)
Organism 50% 90% 50% 90% 50% 90%
Pseudomonas MIC 16.1 (7.6) 52.8 (35.0) 4.8 (2.2) 24.9 (9.8) USiisy (HO), 62 (32.4)
aeruginosa range (8-32) (16—128) (4-8) (11285 32) (8—16) (32—>100)
Serratia MIC 0.325 (0.137) 13.8 (21.8) 14.9 (23.7) 56.0 (53.1) 0.45 (0.13) 9.9 (18.0)
marcescens range (0.25—0.50) (0.25—500) (0.5—50) (16—100) (0.25 —0.6) (0.12—50)
Klebsiella MIC 0.18 (0.21) 0.21 (0.13) el (7) 46.8 (58.3) 0.27 (0.17) 0.90 (0.49)
pneumoniae range (0.02—0.5) (0.06 —0.5) (0.25 —4.0) (1.0—128) (0.10 —0.50) (0:25 =I. 0}
Proteus MIC 0.092 (0.18) 0.12 (0.18) 0.64 (0.44) eal (Glial) 0.23 (0.21) 0.25 (0.18)
mirabilis range (0.0063—0.5) (0.015—0.5) (0.12 —2.0) (0225 oul) (0.06 —0.5) (0.12 —0.50)
Indole-positive MIC 0.16 (0.20) ROON(225) 1.04 (0.94) 4.08 (3.88) 0.21 (0.18) 0.44 (0.32)
Proteus range (0.03—0.50) (0.03—8.0) (0.12—2.0) (0.25 —80) (0.03 —0.5) (0.25 —1.0)
Staphylococcus MIC 2.4 (1.1) 2.59 (1.25) 1.4 (0.8) 3.55 (0.64) 8.0 8.0
aureus range (1.6—4.0) (Of5 eon) (0.8 —2.0) (3.1 —4.0)
(Penicillinase problems)
Staphylococcus MIC 48.7 (69.1) 64.1 (63.0) 2.0 4.0 16.0 16.0
aureus range (2.0—128) (2—>128)
(Methicillin resis.)
Streptococcus MIC 0.035 (0.0247) 0.065 (0.50) 0.06 0.12 1.0 2.0
pyogenes range (0.03—0.05) (0.03 —0.10)
Streptococcus MIC 128 >128 28.5 (4.9) 96 (45) >128 >128
faecalis range (25—32) (64—>100)
Neisseria MIC <0.001 0.04 (0.064) 0.01 0.16 (0.13) _ —
gonorrhea range (O.Cl—OA2) (0.06 —0.25)
E. coli MIC 0.18 (0.15) 0.23 (0.14) 0.34 (0.20) 17.7 (28.0) 0.27 (0.21) 0.32 (0.17)
range (50.03—0.5) (0.06 —0.50) (0.12 —0.50) (1.0—50.0) (0.06 —0.50) (0.12 —0.50)
Enterobacter MIC 0.21 (0.15) 1.96 (3.09) 0.20 0.50 0.19 (0.18) 0.39 (0.36)
range (0.04—0.40) (OMI2Z= 3:0) (0.06 —0.40) (0.12—0.80)
Citrobacter MIC 5.7 (4.0) 48.0 (27.7) 8.0 32.0 8.0 64.0
species range (1.0—8.0) (16.0 —64.0)
Haemophilus MIC 0.015 0.19 (0.39) —_— 0.50 — 0.06
influenzae range (0.03 —0.80)
Salmonella MIC 0.085 (0.05) 0.17 (0.07) 0.40 25.0 — —
range (0.05—0.12) (0.10—0.25)
Bactoroides MIC 25.0 64.0 25.0 100.0 —- —

THE MARYLAND PHARMACIST

TABLE | (Continued)
a a ee ee ee

(CFS) (CTZ)
Cefsulodin Ceftizoxme
MIC (st dev) MIC (st dev)
(range) (range)
Organism 50% 90% 50% 90%
Pseudomonas MIC 3.0 (1.4) 32.0(15.2) 12.5 58
aeruginosa range (2.0—4.0) (16—50) (16—100)
a aie a a | oe Se ee ee ee ee
Serratia MIC — >400 - 0.12
marcescens range
Klebsiella MIC — >400 0.02 0.02 (.014)
pneumoniae range (0.02 —0.05)
Proteus MIC _ >400 =<0.0063 0.032 (0.046)
mirabilis range (<0.0063 —0.06)
Indole-positive MIC — 200 0.02 6.3
Proteus range
Staphylococcus MIC — —
aureus range — —
(Penicillinase problems)
Staphylococcus MIC ~ —
aureus range _— —
(Methicillin resis.)
Streptococcus MIC —_— 6.3 0.058 (0.06) 0.225 (0.035)
pyogenes range (0.015 —0.10) (0.20—0.25)
Streptococcus MIC —_— >900 1.6 >100
faecalis range
Neisseria MIC —_— — 0.20 1.60
gonorrhea range
E. coli MIC — 100 0.20 Oat din(Os13)
range (0.025 —0.25)
Enterobacter MIC a >400 , 0.02 0.12
range
Citrobacter MIC 32.0 128.0 — —
species range
Haemophilus MIC —_— == 0.05 eO)
influenzae range
Salmonella MIC — 50.0 0.02 0.04 (0.01)
range (0.03—0.05)
Bactoroides MIC — — 3.1 25.0

MARCH, 1982 7

A) Cefotaxime
Cefotaxime is active against the following:

1) Enterobacteriaceae (E. coli, Klebisiella, Proteus)
2) Haemophilus influenzae

3) Pseudomonas

4) Serratia marcescens

5) Neisseria gonorrhea (beta-lactamase producing)°
6) Salmonella!

Cefotaxime was shown practically equal to
cefamandole in activity against Haemophilus influen-
zae, including ampicillin resistant strains!’!?. Cefotax-
ime is not active against Streptococcus faecalis and
was not as active as cefamandole and the other third
generation cephalosporins against resistant strains of
Staphylococcus aureus*. Also, compared with other
third generation cephalosporins, its anti-pseudomonal
activity is lower.

Its side effects are infrequent and minor. Cases of
rashes (3.0%)*, diarrhea and loose stools (0.5%)?!°,
phlebitis (1.3%)?, and fatique*® have been reported. In-
vitro studies have shown very low MIC’s, however,
suprisingly, high doses are needed therapeutically de-
spite this activity?°.

B) Moxalactam

Moxalactam is not a true cephalosporin in that an
oxygen is substituted for the sulfur at the one position
(oxa-beta-lactam). Its spectrum is very broad including
Pseudomonas, all species of Enterobacteriace and
anaerobes, including Bacteroides fragilis. Moxalactam
was found to be more active against Bacteroides than
cefoxitine and cefotaxime?!. It is the best third genera-
tion cephalosporin against Haemophilus influenzae? and
in one test was shown to be better than cefamandole!.
Moxalactam is also a good alternative to erythromycin
against Legionella pneumophilia’.

Moxalactam is also different from other cephalospo-
rins in that achievable therapeutic levels in the cere-
brospinal fluid can be obtained!'!°, It crosses only the
inflammed meninges and obtains levels of 20-80% of
serum levels, which are sufficient to inhibit Neisseria
meningitis''. Therefore, CSF levels must be closely
monitored.

Moxalactam is a good alternative to the amino-
glycosides in that its activity is almost equal to the
aminoglycosides but has fewer toxicities and side ef-
fects®. Its side effects are few and less severe than the
older cephalosporins. These include skin rashes, fever,
and nausea®???!,

C) Cefaperazone

This broad spectrum cephalosporin has the lowest
MIC’s of all the new third generation cephalosporins
ce a i a a ata

* 100-1000 times more active than cefoxitin'.
‘30 times more active than cefoxitin'3.

against Pseudomonus®.?!9!?, It is also active against
Enterobacter, Indole-positive Proteus, Serratia marces-
cens, Methicillin resistant Staphylococcus aureus, and
many gram-positive strains that have become resistant
to other beta-lactam antibiotics. It is also a good alter-
native to erythromycin for Legionella pneumophilia.
Cefoperazone obtains high serum levels, has high pro-
tein binding rates, and has a long biological half life
comparable to that of cefazolin.

D) Cefsulodin

Cefsulodin has a narrow spectrum of Pseudomo-
nas, Staphylococcus aureus, and Streptococcus pyo-
genes!>-!4,22, Tt showed no activity against any other
organism tested. It is highly effective against
Pseudomonas and is almost equal in activity to
Cefoperazone. It is as active as gentamicin and tob-
ramycin but without the side effects associated with the
aminoglycosides!8-?,

E) Ceftroxime

Ceftroxime has a broad spectrum which includes

' Bactoroides, Citrobacter, Serratia, Enterobacter, Pro-

teus mirabilis, Klebsiella pneumoniae, E. coli, Sal-
monella, and all gram-positives tested. Ceftroxime is
four times as active as cefotaxime against Salmonella
and was twice as effective against ampicillin resistant
Haemophilus influenzae as cefotaxime’. It is the best
third generation cephalosporin against Serratia marces-
Celisue

F) Cefotiam

Cefotiam is another broad spectrum antibiotic which
has activity against Staphylococcus, Streptococcus,
Enterobacter, Neisseria gonorrhea, Neisseria menin-
gitis, and Haemophilus influenzae. It has poor activity
against Streptococcus faecalis and is inactive against
Pseudomonus.

G) Ro-13-9904 (Roche product)!’

This is a broad spectrum cephalosporin similar in
activity to cefotaxime and moxalactam. It is active
against Bacteroides fragilis, methicillin resistant
Staphylococcus, Streptococcus faecalis, and some of
the Pseudomonas species. It is more active than the
other two against Haemophilus influenzae and Neis-
seria gonorrhae.

IV) Conclusion

The new third generation cephalosporin are an im-
portant improvement over the older ones. The most
note worthy improvement is their activity against
Pseudomonas and other gram-negative organisms com-
pared to the aminoglycosides. They, therefore, may
prove to be good alternatives to aminoglycosides due to
their low toxicities.

THE MARYLAND PHARMACIST

A special thanks to Jerri Formica who allowed me to use her paper
‘*New Antibiotic’’ which was written 3/11/81 for her Advanced Anti-
biotics course at the University of Maryland, School of Pharmacy.

Acknowledgement
|

.

_ Her paper provided the basis for this paper.

TEXTS
1. Goodman and Gilman; The Pharmacological Basis of Therapeu-
tics, Sixth Edition; MacMillan Publishing Co., Inc., New York.
1980.
. Kucers and Bennet; The Use of Antibiotics, Third Edition; Wil-
liam Heinemann Medical Books LTD, 1979, London.

rm

BIBLIOGRAPHY

1. Baker, CA; et al., In Vitro Antimicrobial Activity of
Cefoperazone, Cefotaxime, Moxalactam, Azlocillin, Mezlocillin,
and Other B-Lactam Antibiotics Against Neisseria gonorrheae
and Haemophilus influenzae, Including B-Lactamase Producing
Strains. Antimicrob Agents Chemother Vol. 17, No. 4 pg.
ie Ole

2. Bruch, K. and Blomer, R., “‘Cefotaxime Treatment of Patients
Who Failed to Respond to Previous Antibiotics’’. British Journal
of Clinical Practice Vol. 45, Oct. 1980 p. 270-8.

3. Bulger R. R. and Washington, J. A. I, ‘‘Effect of Inoculum Size
and B-lactamase Production on In-Vitro Activity of New Cepha-
losporins against Haemophilus species’’, Antimicrob Agents
Chemother Vol. 17, No. 3, March °80 pg. 393-6.

4. Counts, GW and Turck, M., ‘‘Antibacterial Activity of a New
Parenteral Cephalosporin-HR 756: Comparison with Cefaman-
dole and Ceforanide. Ibid. Vol. 16, No. 1 pg. 64-8.

5. Delstein, PH and Meyer, RD, ‘‘Susceptability of Legionella
pneumophilia to Twenty Antimicrobial Agents’’, Antimicrob
Agent Chemother, Vol. 18, No. 3, Sept °80, pg. 403-8.

6. Gentry, et al., ‘‘In Vitro Antibacterial Activity of Moxalactam
(ly127935) Against Gram-Negative Bacteria From Hospitalized
Patients.’’ Curr Ther Res, Vol. 28, No. 5, Nov. °80, pg. 611—7.

7. Greenwood, D, et al, ‘‘Comparative In Vitro Activities of
Cefotaxime and Ceftizoxime (FK749): New Cephalosporins with
Exceptional Potency’’, Antimicrob Agent Chemother, Vol. 17,
No. 3, March °80, pg. 397—401.

8. Hall, WH, et al, ‘“‘Comparative Activities of the Oxa-Beta-
Lactam Ly127935, Cefotaxime, Cefoperazone, Cefomandole,
and Ticarcillin Against Multiply Resistant Gram-Negative
Bacilli’’, Ibid. No. 2, Feb. °80, pg. 273-9.

9. Hinkle, AM, et al, ‘‘In Vitro Evaluation of Cefoperazone’’, Ibid.
pg. 423-27.

10. Kurtz, TO, et al, “Comparative In Vitro Activity of Moxalactam,
Cefotaxime, Cefoperazone, Piperacillin, and Aminoglycosides
against Gram-Negative Bacilli’’, Ibid. Vol. 18, No. 4, Oct. °80,
pg. 645-8.

11. Landesmann, SH, et al, ‘‘Diffusion of a New Beta-Lactam
(LY127935) Into Cerebral Spinal Fluid’, American Journal of
Medicine, Vol. 169, July °80, pg. 92-8.

12. Lang, et al, ‘“‘Comparison of Cefoperazone, Cefotaxime, and
Moxalactam Against Aerobic Gram-Negative Bacilli’’,
Antimicrob Agents Chemother, Vol. 17, No. 3, March °80, pg.
488—93.

13. Neu, HC; Aswapokee, N; et al ‘‘HR756, a New Cephalosporin
Active Against Gram-Positive and Gram-Negative Aerobic and
Anaerobic Bacteria’, Ibid. Vol. 15, No. 2, pg. 273-81.

14. Neu, HC and Fu, KP, ‘“‘In vitro Antibacterial Activity and B-
Lactamase Stability of SCE-129, a New Cephalosporin. Ibid.
Vol. 15, No. 5, May °79, pg. 646—50.

15. Neu and Fu, ‘‘Antibacterial Activity of Ceftizoxime a B-
Lactamase Stable Cephalosporin’’, Ibid. Vol. 17, No. 4, April
"80, pg. 583—90.

16. Schadd, VB, et al, ‘‘Clinical Evaluation of a New Broad Spec-
trum Oxa-Beta-Lactam antibiotic, Moxalactam, in Neonates and
Infants’, Journal of Pediatrics, Vol. 98, Jan. 81, pg. 29-36.

17. Shannon, K, et al, ‘‘In Vitro Antibacterial Activity and Suscepti-
bility of the Cephalosporin Ro13-9904 to Beta-Lactamases”’,
Antibacter Agents Chemother, Vol. 18, No. 2, pg. 292-8.

18. Tsuchiya, K and Kondo, M, ‘‘Comparative In Vitro Activities of
SCE-129, Sulbenicillin, Gentamycin, and Dibekacin Against
Pseudomonas’’, Ibid. Vol. 13, No. 3, March °78, pg. 536-9.

MARCH, 1982

19. Verbist, L and Verhaegen, J, ‘‘GR-20263, a New Aminothiozolyl
Cephalosporin with High Activity Against Pseudomonas and
Enterobacteriaceae’’, Ibid. Vol. 17, No. 5, May °80, pg. 807-12.

20. Weinstein, Allan, ‘**The Cephalosporins: Activity and Clinical
Use’’, Drugs 19:137—154 (1980).

21. Wilson, WR, ‘‘A New Broad Spectrum Cephalosporin’’, Mayo
Clin Proc., Vol. 56, Jan. 81, p. 63.

22. Yourassowsky, et al, ‘‘The antimicrobial Activity of the Cephalo-
sporin CGP 7174/E Against Pseudomonas aeruginosa in Com-
parison to Carbenicillin, Pipericillin, and Cefotaxime’’, Curr Ther
Res, Vol. 28, No. 2, Aug. ’80, pg. 203-7.

Board of Pharmacy Policy on
Supportive Personnel

The Board of Pharmacy has an obligation to regulate
professional practice to the extent necessary to insure
public safety through competently performed phar-
maceutical services by licensed pharmacists responsible
for assuring the quality of these services to patients.

Supportive personnel can assist the pharmacist in
the delivery of more meaningful, direct patient services.
These individuals shall be trained and qualified accord-
ing to the standards set by the responsible pharmacist
(i.e., Pharmacist in Charge) to perform routine func-
tions which do not require the use of professional
judgement, in connection with the preparing, com-
pounding, distributing, dispensing, and administration
of medications.

Written control procedures and guidelines for the |
supervision of supportive personnel by a licensed
pharmacist, and for the performance of tasks by these
individuals shall be established by the responsible
pharmacist (i.e., Pharmacist in Charge) who utilizes
them in his/her practice.

.

Fine is President of ASCP

Jerome L. Fine of Baltimore, Maryland, was in-
stalled as 1982 President of the American Society of
Consultant Pharmacists at ceremonies held in Phoenix,
Arizona during the Society’s 12th Annual Meeting. Mr.
Fine was elected in October, 1980 by the ASCP mem-
bership and served as President-Elect of the Society
during the past year. He is a full-time consultant phar-
macist for MSC, a national multi-facility nursing home
organization.

Other officers installed by Immediate Past President
Milton Moskowitz were President-Elect Steven B.
Loevner of Edgemont, Pennsylvania and Vice President
Elliott Tertes of Plainville, Connecticut.

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(301) 233-4545

10 THE MARYLAND PHARMACIST

"AS UPJOHN
PHARMACISTS, THEIR
GREAT SATISFACTION
IS IN HELPING YOU

AND THE PHYSICIAN
MAKE THE RIGHT

DRUG DECISIONS FOR
OPTIMAL PATIENT

© 1982, The Upjohn Company, Kalamazoo, Michigan

MARCH, 1982

Maryland College of Pharmacy

MARYLAND
PHARMACEUTICAL
ASSOCIATION

The Maryland College of Pharmacy was organized
in 1840, and up to 1870, the degree conferred by the
College was ‘‘Licentiate in Pharmacy.’’ (Licentiate:
One who has a license granted by a university to prac-
tice a profession; an academic degree ranking below
that of doctor.)

At the end of the 1870—71 school session the de-
grees conferred at graduation were Licentiate in Phar-
macy*; Master of Pharmacy upon those who evidenced
professional advancement for three years after gradua-
tion; and Doctor of Pharmacy upon those who main-
tained the honor and dignity of the profession for ten
years work after graduation. !

In the latter part of 1871, the College resolved to
confer the degree of Graduate in Pharmacy upon
graduates, instead of Licentiate of Pharmacy.” The
Master and Doctor Degree requirements remained the
same through the 1873—74 session. The Annual Circu-
lars (catalogues) of the Maryland College of Pharmacy
during the period 1875 —90 do not mention the advanced
degrees.

The Annual Cataglogue (1891—92) states that the
professional degree conferred at graduation is that of
Graduate in Pharmacy (Ph.G.). Also at this time, the
following honorary degrees are described. Degree of
Master in Pharmacy (M.P.) may be conferred on such
graduates as have continued in the practice of pharmacy
at least three years after graduating, and who shall have
given evidences of advancement in the sciences of our
profession, such as the Board of Trustees may deem
requisite. Degree of Doctor of Pharmacy (PH.D.), this
College may confer this Degree upon such graduates as
may have continued in the practice of Pharmacy for at
least ten years after graduation, and who, by superior
scientific attainments and services rendered their pro-
fession, shall have gained an honorable reputation
among their fellow-pharmacists, the medical profession,
and the public in general.*

The practice of conferring the Honorary Degrees of
Master of Pharmacy (M.P.) and Doctor of Pharmacy

“ One of the requisites for graduation was attendance upon two full
courses of lectures in a respectable college of Pharmacy, the last of
which shall be in this College. The annual College session commenced
October 18th and terminated February 24.

12

and the Doctor of
Pharmacy Degree

by B. F. Allen, Ph.D.

(PH.D. or Phar. D.) upon graduates who had *‘main-
tained the honor, diginity, etc. of the Profession:”” for
three and ten year periods, respectfully, was discon-
tinued at the end of the 1894—95 session.

Up to the summer of 1894, diplomas (Licentiate or
Graduate in Pharmacy had been conferred upon six
graduates, and that of Doctor of Pharmacy upon fifteen
persons. In 1895, far-reaching and important changes
were made. The college session (for a Ph.G.), which had
been of six months length since 1889, was lengthened to
seven months and additional courses were added.*

Commencing with the session 1896—97, a ‘Post
Graduate Course’’ leading to the degree of Doctor of
Pharmacy (Phar.D.) was offered for the first time. Ad-
mission to this course was open to graduates in Phar-
macy only, and depended upon the applicant’s fitness
for advanced studies, which was determined by the fac-
ulty in each individual case. The chief features of this
course consisted of advanced work in the pharmaceuti-
cal, Chemical and microscopical laboratories as well as a
series of lectures on the different subjects pertaining to
pharmacy. The instruction was almost wholly of a prac-
tical nature, and continued through-out one full session
of thirty-two weeks.

The students were required to devote five whole
days of every week to their work. They were expected
to submit to the Faculty, two weeks before the close of
the session, an original thesis, or dissertation, upon
some work performed by themselves. Also, satisfactory
evidence must be furnished to the Board of Trustees
that the candidate for the degree of Phar. D. had, at
least, four years experience at the prescription counter
of some well-regulated pharmacy.

Students unable to devote the whole time required in
one session to the pursuit of advanced work, were per-
mitted to extend the course over a period of two ses-
sions by notifying the Faculty of such intention, so that
the work may be appropriately divided up. The tuitition
fee for the post-graduate course was one hundred and
twenty-five dollars, and the diploma fee twenty-five
dollars additional.*®

The annual catalogues of the College continued to
list this advanced course through the session of
1899-1900. However, no graduates from this program

THE MARYLAND PHARMACIST

(Phar. D. Degree) were listed in the catalogues during
the period 1896—1900.

From the very beginning of its career, the chief pur-
pose of the College was to prepare its matriculants for
the intelligent practice of Pharmacy as it appears in the
retail drug store. In the face of much adverse criticism
and confusion, with the session of 1900—01, the College
supported the claim that Pharmacy is a profession by
conferring a professional degree—Doctor of Pharmacy
(Pharm. D.). Although some pharmacy colleges had
adopted a three-year course, this College still adhered
to the two-year course (Junior and Senior) both for edu-
cational and financial reasons. But the sessions were
lengthened to thiry-two weeks each.’

To meet the wishes of students who may find it more
convenient to extend their studies beyond the pre-
scribed number of years (two), arrangements could be
made to have the college course extended over three or
more years.®

Cordell? stated, ‘‘In taking this step the College is
believed to have exhibited its usual practical wisdom
and foresight. It is mere justice to students of Phar-
macy, who have spent time and money in mastering the
details of scientific profession, that they should have
full credit for their sacrifices and achievements, and that
their degree should be equal to that granted in other
corresponding professions. The example does not seem,
however, to have commended itself as yet, and recently
(1906) Professor Hynson? has urged its general adoption
by colleges in a paper read before the American Phar-
maceutical Association.”

On May 21, 1901, this higher degree (Pharm. D.) was
conferred,° for the first time, on the following graduates
of the regular course of instruction: J. C. Barbour
(Kentucky), J.J. Barnett (Alabama), B. L. Cole
(North Carolina), W. J. Freeman (North Carolina), S.
Fox (Maryland), A. N. Hewing (Maryland), N. A. Hess
(Maryland), C. H. Hudson (Maryland), J. K. Hanson
(Denmark), R. E. Houston (South Carolina), E. G.
Kiesling (Texas), W. W. Kidd (North Carolina), W. V.
Levy (Maryland), W. F. Moody (North Carolina), L. D.
Pruden (Virginia), H.C. Richardson (West Virginia),
E. M. Stevens (Georgia), C. C. Thome (Pennsylvania),
W.M. Wilson (North Carolina).!!

In 1902, the College deemed it desireable to offer
two graded courses of instruction, one leading to the
degree of Graduate of Pharmacy, the other to the De-
gree of Doctor of Pharmacy. This division was made
because it was believed that some students not desire to
avail themselves of the more extensive and advanced
pharmaceutical knowledge which the higher degree rep-
resented, but prefer to acquire so much as is necessary

> Henry Parr Hynson, Faculty member Maryland College of
Pharmacy, first President of the National Association of Retail Drug-
gists (1898), one of the founders of the well-known Baltimore Phar-
maceutical Company—Hynson, Wescott and Dunning.'°

©“ Commencement exercises held three O’Clock Tuesday afternoon,

Ford’s Opera House, northside Fayette Street east of Eutaw Street.'?

“ Also a Graduate (Ph.G.) of the Maryland College of Pharmacy,
Class of 1899.'3

MARCH, 1982

to fit them for the needs of the practicing pharmacist,
and the requirements of the State Board of Pharmacy.'*

Also at this time, those who previously obtained the
Ph.G. Degree were permitted to enroll in the Doctor of
Pharmacy program. Such candidates if successful in
passing the special examinations arranged for the de-
gree of Doctor of Pharmacy, obtained the higher degree
upon payment of the required fees. On May 20, 1902,
Maryland College of Pharmacy awarded twenty-five
Doctor of Pharmacy degrees and nine Graduate in
Pharmacy Degrees.

In the 1903—04 Annual Announcement the following
is stated: *‘Any graduate of this College may obtain the
degree of Doctor of Pharmacy upon payment of the re-
quired fee and the successful completion of those
courses or parts of courses, in the present curriculum,
which were not taken or were not offered during atten-
dance at this College.’ On May 14, 1903, the degree of
Doctor of Pharmacy was conferred upon fifteen
graduates, and the degree of Graduate in Pharmacy
upon nineteen.!>

On May 13, 1904, eighteen received the Doctor of
Pharmacy Degree and eleven the Graduate in Pharmacy
Degrees?

The Maryland College of Pharmacy, on July 7, 1904,
became the Department of Pharmacy of the University
of Maryland (Northeast corner Lombard and Greene
Streets). Beginning with the 1904—05 school year, the
only degree conferred upon graduation was that of
Doctor of Pharmacy.!'’!® At this time, Cordell! stated
the degree ‘‘as being more consonant with justice and
more in accordance with University usage.”

In 1913, the practice of awarding a Doctor’s Degree
upon successful completion of the required courses, to
an alumnus holding a Graduate in Pharmacy Diploma
was discontinued.?° (On May 3, 1907, the Degree of
Doctor of Pharmacy was conferred upon H. A. B. Dun-
ning,° Ph.G. 1897 and H. L. Whittle, Ph.G. 1893; and on
June 1, 1908 upon Milton R. Walter, Ph.G. 1890).

Beginning with the School session of 1914—15 the
Degree of Graduate in Pharmacy was conferred upon
the completion of the two year course. This degree was
a recommendation of the American Conference of
Pharmaceutical Faculties, meeting held in Nashville,
Tennessee, August 18, 1913. (Relative to standardiza-
tion of degrees with an entrance requirement of one
year’s high school education).?!

As before the union with the University, the organi-
zation of the Maryland College of Pharmacy kept up its
election of officers and meetings: October 20, 1904
Pharmaceutical Hall University of Maryland Dental
Building, Greene Street near Lombard; November 17,
1904 and January 19, 1905 at Tierney’s Hotel, Franklin
and Howard Streets; also in 1905, March 16 Belvedere
Hotel on North Charles Street, July 20 Kent Island
‘*Love Point’’ on the Eastern Shore, and November 16

* One of the founders of the Pharmaceutical Company-Hynson,
Wescott and Dunning.

13

Raleigh Hotel, Fayette and Holliday Streets; in 1906,
January 18 Junker Hotel, 22 East Fayette Street, March
15 and May 17 the Eutaw House, Northwest corner
Baltimore and Eutaw Streets, July 31 Cesterwood, Bear
Creek (Baltimore County); and in 1907, January 18 the
University Dental Building and July 19 Bay shore Park
(near the present location of Fort Howard Hospital);
January 16, 1908 Medical and Chirurgical Faculty Hall
847 North Eutaw Street.”

After a ‘‘sea-food’’ supper in the Casino at the Bay
Shore Park (July 19, 1907 meeting), Hynson made a
motion (passed) that a Committee composed of Cas-
pari’, Dohme® and Dunning confer in regard to granting
the degree of Doctor of Pharmacy to members of the
Maryland College of Pharmacy.7?

At the Annual Meeting of 1908 (January 16) no re-
port was submitted by the Committee elected to con-
sider the feasibility of conferring the honorary Degree of
Doctor of Pharmacy on those graduates of the College
deemed worthy of the honor. Therefore, Hynson then
presented the following resolution (seconded by Wil-
liam J. Lowry, Jr.): ‘‘Resolved, that the Board of Trus-
tees be directed to confer upon all such graduates of the
Maryland College of Pharmacy as graduated previous to
the year 1901 and have continued to be actively engaged
in Pharmaceutical pursuits, the degree of Doctor of
Pharmacy at such time and place as the Board of Trus-
tees may select, provided the Board of Trustees deem
the Graduate worthy of the honor and the graduate shall
pay the sum of ten dollars.’’ After a very lengthy dis-
cussion and some changes in the original resolution, the
entire subject was tabled. There being no further busi-
ness the College adjourned. (This appears to be the last
recorded minutes of the Maryland College of Phar-
macy.)

It is interesting to note some of the objections to the
granting of the Degree: the Maryland College of Phar-
macy was no longer a teaching College, the wording of
the resolution conveyed the impression that the Degree
was to be purchased, those who did not receive the
Degree would naturally resent the slight, conferring of
the degree be subject to the present requirements of the
Pharmacy Department University of Maryland.

The following are some of the recipients of early or
honorary Doctor of Pharmacy Degrees from the Mary-
land College of Pharmacy or the University of Mary-
land. (Figure in parentheses following the name indi-
cates the year awarded.): George W. Andrews (1869), J.
Brown Baxley (1869), Charles Caspari, Jr. (1905),
Charles E. Dohme (1907), Louis Dohme (1869, James P.
Frames (1870), Israel J. Gratiame (1871), John F. Han-
cock (1907), Henry P. Hynson (1907), H. Hynson Jen-
nings (1869), J. Faris Moore (1869), William Procter, Jr.

‘Charles Caspari, Jr., Pharmacy Professor and Dean of Pharmacy
Faculty University of Maryland.

* Probably, Charles E. Dohme a partner in the well-known Balti-
more Pharmaceutical manufacturing firm Sharp and Dohme (South-
west corner Pratt and Howard Streets). Today this company is known
as Merck, Sharp and Dohme.

14

(1871), Joseph Roberts (1870), E. Walton Russell (1869),
Alpheus P. Sharp (1869), J. Jacob Smith (1869), Edward
R. Squibb (1873), David Stewart (1871), William S.
Thompson (1869).

REFERENCES

1. Annual Circular, Maryland College of Pharmacy, Session
IMeSs7Q= TL. yoy,

2. Ibid., Session 1871—72, p. 10.

3. Annual Catalogue, Maryland College of Pharmacy Session
1891 —92, p. 35.

4. Eugene F. Cordell, ‘‘ University of Maryland,’ Volume-1, Lewis
Publishing Company, New York-Chicago, 1907, p. 432.

5. Annual Catalogue, Maryland College of Pharmacy, Session
1895—96; p: 17:

6. Ibid., Session 1896—97, p. 17.

7. Annual Announcement, Maryland College of Pharmacy, Session
1900—O1, pp. 4, 6, 7, 26.

8. Ibid., Session 1901—02, no page number.

9. Reference 4, p. 434.

10. Wedgwood Club, Baltimore, Seventy-Fifth Anniversary
(1900-1975) Booklet (Edward W. Piper, Historian) p. 12.

l eeReference 8

12. Minutes of the Maryland College of Pharmacy 1888—1908, p. 193.

13. Annual Catalogue, Maryland College of Pharmacy, Session
1899—1900, p. 27.

14. Annual Announcement, Maryland College of Pharmacy, Session
1902 —03, no page number.

15. Ibid., Session 1903—04, pp. 6, 22.

16. Annual Announcement, Maryland College of Pharmacy (Depart-
ment of Pharmacy of the University of Maryland) Session
1904—05, p. 20.

WeRetcrencema pare oss

18. Reference 16, p. 6.

19. Reference 4, p. 440.

20. Annual Announcement, University of Maryland, Department of
Pharmacy (Formerly the Maryland College of Pharmacy), Ses-
sion 1913—14, p. 6.

21. Ibid., Session 1914—15, p. 6.

22. Reference 12, pp. 241, 243—245, 247—250, 252-254.

23, Morel. ( 23.

calendar <S

Mar. 7 (Sun)—AZO Fraternity Dinner Meeting

Mar. 8—11—NARD Legislative Conference, Wash-
ington, D.C.

Mar. 14 (Sun)—Alumni Association Dinner Meeting

Mar. 28—MPhA Spring Regional Meeting, Kelly
Building

April 24—29—APhA Convention, Las Vegas

June 18—20—Maryland Society Hospital Pharmacist
Seminar, Williamsburg

June 20—24—MPhA CENTENNIAL CONVEN-
TION, OCEAN CITY

Nov. 4—7—SAPHA REGIONAL CONVENTION
IN BALTIMORE

THE MARYLAND PHARMACIST

Dog work: counting inventory, filing, Keeping up-to-date price lists: that’s not what we
went to school for. But it takes up too many hours in a pharmacist’s day. Bob Bergstein
and Jon Johnson of the Clinton Pharmacy, Clinton, MD, found the answer in the IBM QS/1
System.

Jon Johnson says, ‘Our Medicaid volume runs in excess of $10,000 per month, and the
turn-around time from submission to cashing of the check has been cut from 34 to nine
days. Our Aetna payments are now paid within days against the old system which took
almost two months. At 2% a month, the interest on that money alone almost justifies the
cost of the machine.”

Bob Bergstein concurs. “The QS/1 posts charges and third party plans automatically;
prices prescriptions; prints labels — it takes only three seconds to print a refill label,’’ Bob
notes.

Call Jon Johnson or Bob Bergstein at the Clinton Pharmacy, (301) 868-2000.
They'll give you a free demonstration of the QS/1 on the job. It’s easy to lease. Now’s the
time.

Credential Computer Associates
P.O. Box 1967 - 2525 N. Seventh Street, Harrisburg, Pennsylvania 17105

MARCH, 1982

15

Feinberg on APhA Office
of Women’s Affairs

At its January 1982 meeting, the APhA Board of
Trustees inaugurated the Office of Women’s Affairs
(OWA) with the appointment of an advisory group to
spearhead this effort. Under the guidance of the advi-
sory group, the OWA will be responsible for developing
plans to implement the recommendations of APhA’s
Task Force on Women in Pharmacy. Stressing profes-
sional unity, the office will interact with other interested
groups and individual pharmacists throughout the na-
tion to encourage the involvement of women in associa-
tion activities at the national, state, and local levels.
Projects emanating from this new office will be coordi-
nated with existing APhA services provided to
members—both women and men pharmacists in differ-
ent practice areas.

Members of the 1982 OWA advisory group are:

@ Pharmacist Dena L. Barker, assistant dean for
student affairs, Howard University College of
Pharmacy and Pharmacal Sciences, Washing-
ton, DC;

@ Pharmacist Madeline V. Feinberg, community
practitioner, Silver Spring, MD, and clinical in-
structor at the University of Maryland School of
Pharmacy;

@ Pharmacist Charma A. Konnor, pharmacist re-
viewer, Food and Drug Administration—OTC
Drug Evaluations, Rockville, MD, and clinical
instructor at the Medical College of Virginia
School of Pharmacy; and

@ Pharmacist Marian R. Ricardo, director of phar-
macy services, Simpson House, Philadelphia,
PA.

APhA staff member Gloria N. Francke will chair the
advisory group, and Vivian L. Emala will serve as staff
contact for the Office of Women’s Affairs.

Development of a communications mechanism and a
networking system will be among the first projects that
the advisory group will consider at its meeting in Feb-
ruary 1982. Representatives of the Office of Women’s
Affairs will be available at the 1982 APhA Annual
Meeting in Las Vegas for informal discussions related to
implementation of the recommendations of the APhA
Task Force on Women in Pharmacy. APhA members
involved in state task forces and other organizations
with program suggestions for the OWA are urged to
establish liaison with APhA staff.

The Final Report of the APhA Task Force on
Women in Pharmacy is available from the APhA Task
Force on Women in Pharmacy is available from the
APhA Order Desk, 2215 Constitution Avenue, NW,
Washington, DC 20037 for $10.00 ($15.00 for nonmen-

bers).

16

ASHP comes to Baltimore

Baltimore is the place to be on June 6-10 for ASHP’s
39th Annual Meeting. This Annual Meeting combines gen-
eral sessions, contributed papers, exhibits, House of Dele-
gates’ activity, and several new features. Continuing edu-
cation certification will be offered for nearly all sessions.

The CE program is built around four general sessions,
one of which is held each morning of the meeting. The
topics selected for this year’s meeting will stimulate atten-
dees to think beyond their own practices and beyond in-
stitutional practice. ‘‘Corporate Influences in the Delivery
of Health Care’’ is the theme for the opening general ses-
sion on Monday; ‘‘Opportunities and Experiences In-
volving Investigational New Durgs,’’ ‘‘Clinical Implica-
tions of the New Calcium-Channel Blocking Agents,’’ and
‘‘Modern Management Concepts’’ will follow on Tuesday,
Wednesday and Thursday, respectively.

ASHP’s House of Delegates, the Society’s major
policy-making body, will convene on Monday and Wed-
nesday afternoons. Preceding those meetings will be the
Open Hearing, which provides an opportunity for all
ASHP members to discuss Society policies or professional
concerns with officers, Board members, and chairmen of
the councils.

Information on Annual Meeting registration and ac-
commodations is available from ASHP headquarters on
request.

Specialty Board
Approves Nuclear
Specialty Examination

The Board of Pharmaceutical Specialties (BPS) met
recently in Washington, DC, and approved the specialty
certification process for nuclear pharmacists. Approval
was based on recommendations made to the BPS by its
Specialty Council on Nuclear Pharmacy which had been
developing the certification program for over two years.
The Council consists of six nuclear pharmacists ap-
pointed by the American Pharmaceutical Association’s
Academy of Pharmacy Practice Section on Nuclear
Pharmacy and three non-nuclear pharmacists appointed
by the BPS.

The certification process consists of a 4,000-hour
experience requirement and a 300-question certification
examination. The all-day examination will be adminis-
tered on Saturday, April 24, 1982, simultaneously in Las
Vegas, Nevada, and Atlanta, Georgia. Candidates in-
terested in sitting for the examination should request an
application form and additional details from BPS
executive secretary Richard P. Penna, 2215 Constitu-
tion Avenue, NW, Washington, DC 20037.

THE MARYLAND PHARMACIST

Third Party Committee

Many pharmacies have seen their third party prescriptions climb to over half of their total volume, requiring a greatly increased
paper-work load. Since almost all programs except Medicaid require the use of the Universal Claim Form which does not provide an
identifiable space for the name of the drug, the use of National Drug Code (NDC) numbers is now routine.

The NDC number is broken into three portions. The first identifies the labeling company, and is assigned by FDA. The second and
third sets are assigned by the company itself and identify the particular product, and the package size respectively. There often is an
advantage to be able to tell the name of the company from the NDC number when reviewing claim forms. The accompanying list
provides the NDC number for many of the companies. Often a company has been assigned more than one number to identify the
division (Smith Kline French, SKF, etc.) or the place of manufacturer (Roche-USA, Roche-Puerto Rico).

0044
0045
0046
0047
0048
0049
0052
0053
0056
0057
0058
0060
0062
0064
0065
0066
0067
0068
0069
0070
0071
0072
0074
0075
0077
0078
0081
0082
0083
0085
0086

LILLY

SQUIB

ROCHE

LEDERLE

MSD

SKF

WYETH

UPJOHN

PHILIPS ROXIANE INC
HWD

ADRIA LABS
SEARLE

BRISTOL LABS
PHARAMACIA
WAMPOLE LAB
PENWALT
MALLINCKRODT
REED & CARNICK
ALLERGAN
WINTHROP
SEARLE LAB
DOME LAB
HOLLAND-RANTOS
GEIGY
BEECH-MAS LABS
ROBINS

SYNTEX

PURDUE FREDERICK
WALLACE PHARM
STUART ICI
HOECHST PHARM
COOPER

DORSEY

KNOLL

MCNEIL

AYERST

WARNER CHILCOTT LAB
FLINT

ROERIG
ORGANON
ARMOUR PHARM

ENDO INC
ORTHO
TEXAS PHARM
ALCON
DERMICK
RORER
MERRELL
PFIZER

USV LABS PR
PARKE DAVIS
WESTWOOD
ABBOTT

USV
BARNES-HIND

CIBA
SCHERING
CARNRICK

MARCH, 1982

0087
0088
0089
0091
0094
0107
0108

National Drug Code (in numerical sequence)
Manufactures Reference Numbers

MEAD JOHNSON
MARION LABS
RINKER

KREMER URBAN
ARNAR STONE
ORTHO PHARM PR
SK & F LAB
ALLERGAN CAR
RICHYN

CORD
HOLLISTER STIER
REXALL

HOYT LABS
PEE)

J&J

FULLER LABS
AMFRE-GRANT
STIEFEL
NORWICH-EATON
CUTTER LABS
ELDER

FOUGERA
ZENITH

GENERIX DRUG
DOW PHARM
VITARINE

ASTRA

ICN PHARM
AMES CO
RACHELLE
LEDERLE PARENTE
LEDERLE METHOTR
DOONER
PUREPAC PHARM
SCHMID
STANLABS PHARM
UPSHER SMITH
FLEMING
INWOOD LABS
PANRAY

PREMO
BIOCRAFT
BAXTER LABS
FEDERAL PHARM
PARMED

SCHEIN

KEY PHARM
MYLAN

GEBAUER
HUMCO

MURO

O'NEAL, JONES, FELD.
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ie

You really have a lot to offer...

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ILETIN I

beef-pork insulin

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For most diabetics . . . Iletin I

All Lilly insulin preparations bearing the
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diabetics manage their diabetes most ef-
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many forms of Lilly insulin that are cur-
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the purity of its insulin products signifi-
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than 50 parts per million of proinsulin
(proinsulin content is the standard mea-
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ILETIN I

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purified beef insulin

Additional information available
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THE MARYLAND PHARMACIST

IF I HAD MY LIFE
TO LIVE OVER

I'd dare to make more mistakes next time. e
I'd relax, I would limber up.

I would be sillier than I have been this trip.

I would take fewer things seriously.

I would take more chances.

I would climb more mountains and swim more rivers.

I would eat more ice cream and less beans.

I would perhaps have more actual troubles, but I'd have fewer imaginary ones.

You see, I’m one of those people who live sensibly and sanely hour after hour, day after day.
Oh, I’ve had my moments, and if I had it to do over again, I’d have more of them.
Just moments, one after another, instead of living so many years ahead of each day.
I’ve been one of those persons who never goes anywhere without a thermometer,
a hot water bottle, a raincoat and a parachute.
If I had to do it again, I would travel lighter than I have.

If I had my life to live over, I would start barefoot earlier in the spring
and stay that way later in the fall.

I would go to more dances.
I would pick more daisies.

This page donated b
Brann p eet: 7 Pictures courtesy Abe Bloom — District Photo

Photo Service.

DISTRICT PHOTO ING

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

MARCH, 1982 19

LETTERS

Dear Mr. Banta:

We are pleased to announce the availability of two re-
vised joint statements of the American Thoracic Society
and Centers for Disease Control, Diagnostic Standards
and Classification of Tuberculosis and Other Mycobac-
terial Diseases and The Tuberculin Skin Test. Copies
are enclosed for your review. We would appreciate
your announcing the availability of these statements in
the next edition of the Maryland Pharmacist. Free
copies are available by contacting our Association at
the telephone number noted below.

Although tuberculosis is a curable and preventable
disease, it continues to be transmitted. In 1980, tuber-
culosis in Maryland remained above the national average
with 610 cases reported, representing a case rate of 14.5
per 100,000 population. The Centers for Disease Control
ranked Maryland 13th and Baltimore City 5th as com-
pared to other State and city case rates. Nationally, the
year 1980 was the first time since 1963 that there has
been an actual increase in the number of new cases of
tuberculosis. Tuberculosis is the third leading reportable
infectious disease and the second leading cause of in-
fectious disease deaths in the United States. As a result
of President Reagan’s recent budget cuts, federal funding
for local tuberculosis control programs has been elimi-
nated. We believe that a national commitment is manda-
tory if we are to reduce the continuing transmission of
tuberculosis.

Sincerely,

Gina Westfall

Director

Adult Lung Disease Programs
American Lung Association
(301) 685-6484

Dear Dave:

In an effort to control the theft and forgery of
Franklin Square Hospital prescription blanks, we have
revised both the form and their procedure for use. Ef-
fective December 1, 1981, the white Franklin Square
Hospital prescription blanks have been replaced with
two new blanks, a green prescription blank marked
‘*Controlled Substances”’’ and a white blank bearing the
statement ‘‘Not Valid For Schedule II Substances’’. At
present, only Schedule II drugs are required to be writ-
ten on the controlled substance blank. Schedules III,
IV, and V may still be written on the white blanks. Both
forms are serially numbered and their distribution
within the hospital recorded by the pharmacy.

20

Please be aware that during the phase in period,
there may still be patients with prescriptions written on
the old forms. We request that community pharmacists
exercise professional judgement during the phase in pe-
riod.

If you have any questions concerning the validity of
a prescription, please call the pharmacy at 391-3900,
extension 5381 for assistance.

Sincerely,
Roger G. Heer, R.Ph.
Director of Pharmacy

Dear Mr. Banta:

In response to your letter request, I have described
below recent changes in Glenbrook products. Meth-
apyrilene fumarate has been removed from Cope after
it was found to be a possible carcinogen. None of our
products contain tartrazine (Yellow Dye #6). Bayer
Aspirin is now available with a thin coating which elimi-
nates all aspirin aftertaste and prevents tablets from
flaking during storage without interfering with aspirin’s
bioavailability. Two Diaparene baby products have had
a name switch corresponding to the product’s consis-
tency. Diaparene Ointment is now called Diaparene
Medicated Creme and Diaparene Peri-Anal Creme is
now called Diaparene Peri-Anal Ointment. I do not
anticipate any other product changes in the near future.

The following products are no longer manufactured
by Glenbrook Laboratories:

Bayer Acetaminophen Non-Aspirin Pain Reliever

Bayer Decongestant Cold Tablets

Breacol Metholated (Breacol Regular still available)

Dr. Lyon’s Tooth Powder

Fizrin

Jayne’s P.W. Vermifuge

Phillips’ Toothpaste

Phillips’ Milk of Magnesia, Chocolate Flavored
(Regular and Mint Flavored Phillips’ Milk of
Magnesia Is still available).

ZBT

The general policy at Glenbrook Laboratories re-
garding “‘flagging’’ of product changes is to flag major
product changes and not to flag minor product changes.

If you need additional product information, please
contact me.

Sincerely,
Katherine Farragher
Research Assistant

THE MARYLAND PHARMACIST

Announcing the Reactivation of the

EMPLOYEE—EMPLOYER
RELATIONS FORUM

The purpose of the Forum is to deal creatively with the issues in Maryland Pharmacy employer and
employee relations. This Committee of the Association is made up of individuals from a wide variety
of practice settings. We are asking for input on current employment issues from all segments of the
profession. The Forum will act as a ‘‘sounding board’ on these issues and will provide some

ombudsman activity.

MARYLAND
PHARMACEUTICAL
ASSOCIATION

The 100th anniversary of the Maryland Phar-
maceutical Association and the 25th anniversary of my
licensure as a pharmacist seemed an appropriate time
to comment on the state of the profession.

1. Pharmacists are overtrained and/or unde-
rutilized.

2. Courses being taught are irrelevant to our needs.

3. Physicians will not listen to my advice, even if I
choose to give it.

4. Chain pharmacies make it impossible for the in-
dependent to survive.

5. Fees for welfare prescriptions are too low.

All these were said during the 1950's.

There is no doubt an element of truth to each of
those statements now as there was then. There must
always be pharmacists who are ‘‘overtrained’’ to take
advantage of opportunities to grow professionally.

How is relevance determined? Although most
graduates choose hospital or community practice, stu-
dents are prepared for numerous other areas of en-
deavor. What is relevant to one area could be well be
totally unnecessary in another. No one in 1957 could
say for sure what would be relative for 1982. Similarly,
no one today can be certain what will be relative for the
year 2007.

That physicians will not listen to pharmacists is an
alibi many of us use to excuse our own inaction.

Independent pharmacies are still around, even
though not in the numbers as before. In fact, chains may

MARCH, 1982

We are asking for your help in submitting issues to the Forum for
comment and response. If you have a suggestion, idea, or comment,
contact the Employer/Employee Relations Forum at: 650 W. Lombard
St., Baltimore, Md. 21201.

The reactivation of the Employer—Employee Relations Forum coin-
cides with the Association’s Centennial. The Committee decided that
there are many favorable sentiments about the profession of pharmacy
and what it means to members that are often left unspoken. During the
Centennial year members are asked to express in a positive way what
pharmacy means to them. Here is one such sentiment:

have done the independents a favor by compelling them
to become both efficient and effective. The marginal
practitioners, those who can’t or won’t change are no
doubt being eliminated. There are limits to the number
of no-service, low price patrons. There is a market
awaiting the service oriented practitioner.

For the individual with the desire to take the initia-
tive in the home health care field, there are at least as
many opportunities as 25 years ago. There are oppor-
tunities in the traditional roles as hospital or community
practitioners as well as related and new areas. There are
clinical roles for the pharmacist in hospitals, and nursing
homes as well as other institutions. The more innova-
tive among us will develop and expand the clinical role
of the community pharmacist.

In 25 years, only the name has changed; now it’s
Medicaid fees that are too low.

I suspect that 100 years from now, someone will be
writing these same things. The opportunities have al-
ways been and will always be there for those with the
forethought to set goals, a conviction in the value of
their goals and a willingness to expend the effort to
attain them.

The more the change, the more things stay the same.

Marvin L. Oed, Pharm. B.S., P.D.
Clinical Assistant Professor
Department of Pharmacy Practice
and Associate Director
Professional Experience Program

When

was the
last time
your
insurance
agent

gave you

a check...

that you

‘didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville. Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
ANTHONY G. PADUSSIS EVERY YEAR!
Usually for more than 20% of his premium.

TONY is one of the many Maryland pharmacists
participating in the Mayer and Steinberg/

MPhA Workmen's Compensation Program—
underwritten by American Druggists

Insurance Company. |

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS
call or write:

Your American Druggists’ Insurance Co. Representative

9 AMERICAN
ONY DRUGGISTS’
INSURANCE

Please contact me. | am interested in receiving more

information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. O Call O Write.

Trojans
ck 8 profit...

TUT Oe
Oe Oost 12

sescaaye SAS es
PEERS A RRR hl NR

li

TROYAN ®

Family Planning Center

slilililalalil

v a
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A well-stocked TROJANS® display rack can really pack a profit into a few
feet of counter space. Because more TROJANS are sold to consumers in
drugstores than all other brands combined...this delivers $2.30 for every dollar
you invest (ROI).

Today the condom market has reached an all time high in sales. More and
more people are rediscovering the condom as they search for a safe, effective
method of contraception without side effects.

TROJANS are backed by a big national advertising program that helps you
have a faster turnover. No wonder TROJAN brand condoms are recom-
mended by more pharmacists than all other brands put together.

Ask your TROJAN territory manager for complete display information or
write us to find out how to get your share of this most profitable line.

pe ee eee dietician

Trojans®..the number one brand of condom sold in drug stores.

YOUNGS DRUG PRODUCTS CORPORATION
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R)
Whilenocontraceptive provides 100% protection, TROJAN brandcondoms, when properly used, effectively aidinthe prevention of pregnancy and venerealdisease.

MARCH, 1982 as

Are you taking advantage of all the
proven methods to promote a phar-
macy's prescription department?

If not, SK&F’s newest 30-minute video-
tape program can start you thinking
about the opportunities you may be
missing.

Our new management program is called
Promoting Your Prescription Depart-
ment—and it’s designed as a seminar
for interested groups of community
pharmacists.

You can learn more about advertising,
promotional budgets, personal selling,
publicity, pharmacy layout, and evalua-
tion of your promotion efforts.

alinislaicann

aag(aals
LAK PAYS

ARE YOU

“SELLING”
YOUR
PRESCRIPTION
DEPARTMENT?

Promoting Your Prescription Depart-
ment is one more valuable addition to
the pharmacy management series now
available from SK&F.

Ask your SK&F Representative how you
can obtain this videotape program for
your next meeting.

©SmithkKline Corporation, 1982

SIXGF

a SmithKline company

Smith Kline &French Laboratories
Philadelphia, Pa

THE MARYLAND PHARMACIST

To keep drug product selection a workable
concept, pharmacists need information about
the source of drug products before they pur-
chase them.

The California Pharmacists Association
wrote to drug manufacturers and distributors,
asking them to provide new and updated in-
formation on which companies actually man-
ufacture the final dosage form. On these

pages is the latest information provided to the association.

We have added some drugs to the list because they are now available from a greater number of sources. All
information concerning the manufacturers of drug products applies only to those dosage forms and
strengths distributed by the companies. The distributor appears on the left, the manufacturer on the right.

Continued from February

Towne, Paulsen & Co.— — ~ — Barr Labs

Vangard Labs’ M.D. Pharm.

Wallace Labs Carter-Wallace

West-Ward* Halsey Drug Co.

Wolins Pharmacal* M.D. Pharm.

or Generic Pharm.

Doxycycline Hyclate? 50 mg caps

Geneva Generics

Rachelle Labs (100 mg)
Ladco Labs

Rugby Labs!

or Rachelle Labs
Rachelle Labs
Pfizer Pharm.
Rachelle Labs
Rachelle Labs
Danbury Pharmacal
Rachelle Labs

Erythromycin Base 250 and 500 mg tabs
Abbott Labs Abbott Labs
Dista Products Co Eli Lilly & Co.
A.H. Robins A.H. Robins
The Upjohn Co The Upjohn Co.

Erythromycin Stearate 250 and 500 mg tabs
Abbott Labs Abbott Labs
H.R. Cenci Labs Zenith Labs
Coast Labs Mylan Pharm.
Geneva Generics
ICN Pharm.*
Ladco Labs

Parmed Pharm
Pfizer Pharm
Rugby Labs
Vangard Labs’*
West-Ward*
Wolins Pharmacal*

Barre Drug Co.
Rugby Labs'

or Mylan Pharm.
Lederle Labs
McKesson Labs* Barr Labs (250 mg)
Mylan Pharm. (500 mg)
Parke-Davis

Barr Labs, Zenith Labs,
Mylan Pharm. or Richie
Barr Labs

Pfizer Pharm.

Purepac

Mylan Pharm.

Mylan Pharm.

or Chelsea Labs

Smith Kline & French — - — — Mylan Pharm.

E.R. Squibb & Sons E.R. Squibb & Sons
Towne, Paulsen & Co.— — — — Mylan Pharm.

Vangard Labs* Mylan Pharm.
West-Ward* Zenith Labs

Wolins Pharmacal* Zenith Labs

or Barr Labs (250 mg)
Mylan Pharm.

Mylan Pharm.

Parke-Davis
Parmed Pharm

Penta Products
Pfipharmecs
Purepac

Rexall Drug Co.
Rugby Labs

Wyeth Labs

Ferrous Gluconate 300 or 325 mg tabs
H.R. Cenci Labs
Coast Labs
Geneva Generics
Invenex Pharm.*
Lederle Labs
Parmed Pharm.

Cord Labs or Tablicaps
Invenex Pharm.

KV Pharm.

Bolar Pharm.

or Richlyn Labs

MARCH, 1982

Mylan Pharm. or Zenith Labs

Barr Labs or Mylan Pharm.

Cord Labs or Richlyn Labs
Phoenix Labs or Tablicaps

Penta Products
Rugby Labs
Vangard Labs*
West-Ward*
Wolins Pharmacal*

Tablicaps
Chelsea Labs
Richlyn Labs
Richlyn Labs
Tablicaps
or Richlyn Labs
Ferrous Sulfate 300 and 325 mg tabs
H.R. Cenci Labs -- —- - - — - Richlyn Labs or Tablicaps
Coast Labs Phoenix Labs
or West Coast Labs
Cord Labs or Tablicaps
Invenex Pharm.
ICN Pharm.

Geneva Generics
Invenex Pharm.*
ICN Pharm.*
Lederle Labs

Eli Lilly & Co.
Parke-Davis

Eli Lilly & Co.
Parke-Davis

Richlyn Labs

or Standard Labs
Richlyn Labs

Philips Roxane
Purepac

Chelsea Labs

W.T. Thompson

or Chase Chemical
Towne, Paulsen & Co.— - ~ — Towne, Paulsen & Co.
Vangard Labs* Drummer Labs
West-Ward* Standard Pharm.
Wolins Pharmacal* Tablicaps or Richlyn Labs

Parmed Pharm.

Penta Products
Philips Roxane
Purepac

Rugby Labs
Stayner Corp.

Fluocinolone Acetonide 0.025% and 0.01% cream
Allergan Pharm. Marion Labs
Parmed Pharm. Thames Pharm.
Rugby Labs Clay Park Labs
Syntex Labs* Syntex Labs

Glutethimide 0.125, 0.25, and 0.5 gm tabs
H.R. Cenci Labs Zenith Labs
Coast Labs
Geneva Generics
Ladco Labs

Cord Labs
Rugby Labs! or
Chelsea Labs
Cord Labs
Cord Labs
Cord Labs
Chelsea Labs
Cord Labs

McKesson Labs*
Parmed Pharm.
Purepac

Rugby Labs
Stayner Corp.
Vangard Labs*
Wolins Pharmacal* M.D. Pharm., Lannet Co.
or Danbury Pharmacal

Hydralazine HCI 25 and 50 mg tabs
Barr Labs Barr Labs
H.R. Cenci Labs
Ciba Pharm.
Geneva Generics
Lederle Labs

Ciba-Geigy
Cord Labs or Zenith Labs
Lederle Labs

Barr Labs

Zenith Labs or Par Pharm.

Premo Pharm., Zenith Labs

or Cord Labs

bo
Nn

Manufacturer
disclosure

Penta Products
Purepac — — — =

Rexall Drug Co.

Stayner Corp.

Towne, Paulsen & Co.— - — —
Vangard Labs*

West-Ward"

Whiteworth
Wolins Pharmacal*

Hydrochlorothiazide 50 mg tabs

Hydrochlorothiazide, Reserpine, Hydralazine tabs

Hydrocortisone %4%, ¥2% and 1% cream or ointment

26

Abbott Labs
Barr Labs
H.R. Cenci Labs
Ciba Pharm.
Coast Labs
Geneva Generics
Ladco Labs

Lederle Labs

Lemmon — — -
McKesson Labs*
Merck Sharp & Dohme
Parke-Davis
Parmed Pharm.

Penta Products

Philips Roxane

Purepac

Rexall Drug Co.

Rugby Labs

Smith Kline & French — — —- —-
Stayner Corp.

E.R. Squibb & Sons

Towne, Paulsen & Co.— —- - —
Vangard Labs*

West-Ward*

Whiteworth

Wolins Pharmacal*

Coast Labs
Geneva Generics
Lederle Labs
Parmed Pharm.

Purepac
Rowell Labs
Rugby Labs
Stayner Corp.

Barr Labs

Barr Labs (25 mg)

and Cord Labs (50 mg)
Barr Labs

Cord Labs

Barr Labs

Barr Labs

Danbury Pharmacal (25 mg)
Richlyn Labs (50 mg)
Cord Labs

Danbury Pharmacal,
Barr Labs, Zenith Labs
or Premo Pharm.

The Upjohn Co.
Vangard Labs”
West-Ward*
Wolins Pharmacal”

Abbott Labs
H.R. Cenci Labs
Coast Labs
Geigy Pharm.
Geneva Generics
Ladco Labs

Abbott Labs

Barr Labs

Camall Co.

Ciba-Geigy

Camall Co.

Cord Labs

Rugby Labs!

or Chelsea Labs

Barr Labs or Lederle Labs
Reid-Provident Labs
Inwood Labs

Merck Sharp & Dohme

Lederle Labs
McKesson Labs’
Parmed Pharm.

Penta Products
Philips Roxane
Purepac

A.H. Robins

Abbott Labs

Zenith Labs, Bolar Pharm.,
Heather Drug Co. or Premo
Barr Labs

Philips Roxane

Bolar Pharm. or Cord Labs
Camall Ca.

Chelsea Labs

Philips Roxane

Generic Pharm.

Mylan Pharm.

Towne, Paulsen & Co.
Generic Pharm.

West-Ward

Zenith Labs

Zenith Labs, Generic Pharm.,
Chromalloy Pharm.

or Camall Co.

Smith Kline & French
Stayner Corp.

Vangard Labs*
West-Ward*
Wolins Pharmacal*

Isoniazid 100 mg tabs
Barr Labs
H.R. Cenci Labs
Geneva Generics

Eli Lilly & Co.
McKesson Labs*
Merrell Dow Pharm.
Parmed Pharm.
Penta Produots
Purepac

Rugby Labs

E.R. Squibb & Sons
Stayner Corp.

Camall Co. or Bolar Pharm.
Ciba-Geigy

Bolar Labs

Zenith Labs

Danbury Pharmacal

Camall Co. or Zenith Labs

Vangard Labs*
West-Ward*
Wolins Pharmacal*

Rugby Labs —— -

Towne, Paulsen & Co.- — —- -

Towne, Paulsen & Co.— — — -

Purepac
Rowell Labs
Clay Park Labs
Ambix Labs

Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.

The Upjohn Co.
Schaeffer-Davis
Biocraft Labs
Schaeffer-Davis
or Ambix Labs

imipramine 10, 25 and 50 mg tabs

Abbott Labs
Bolar Pharm.
Cord Labs
Ciba-Geigy
Cord Labs
Rugby Labs!

or Chelsea Labs
Biocraft Labs

- Biocraft Labs

Premo Pharm.

or Bolar Pharm.
Biocraft Labs

Philips Roxane

Bolar Pharm.
Biocraft Labs
Chelsea Labs

Smith Kline & French
Cord Labs or Philips Roxane
Biocraft Labs

Bolar Pharm.
Biocraft Labs
Biocraft Labs

Barr Labs

Zenith Labs or Richlyn Labs
Zenith Labs (100 mg)

or Bolar Pharm. (300 mg)
Eli Lilly & Co.

Danbury Pharmacal

Merrell Dow Pharm.

Zenith Labs or Bolar Pharm.
Barr Labs

Purepac

Chelsea Labs

E.R. Squibb & Sons

Barr Labs

Towne, Paulsen & Co.
Danbury Pharmacal
West-Ward

Ormont or Bolar Pharm.

Penta Products Danbury Pharmacal

Purepac — —

— — Bolar Pharm.

Isosorbide Dinitrate 5, 10, 20, 30 & 40 mg tabs or caps

cublingual and/or oral

Rugby Labs
Stayner Corp.
Towne, Paulsen & Co.— -— — — Bolar Pharm.

Barnes-Hind Pharm.
Burroughs Wellcome Co. — —
H.R. Cenci Labs

Coast Labs

Dermik Labs

Drummer Labs

E. Fougera & Co.

Geneva Generics

Ladco Labs
Lemmon

Life Labs
Miles Pharm.
Owen Labs”
Parke-Davis
Pfeiffer
Parmed Pharm. -— — —

Penta Products
Pfipharmecs

Chelsea Labs

Danbury Pharmacal Barr Labs

H.R. Cenci Labs
Coast Labs
Ives Labs* — — —

Geneva Generics
Ladco Labs

Barnes-Hind Pharm.
Burroughs Wellcome Co.
H.R. Cenci Labs
Chemrich Pharm.
Dermik Labs

Lederle Labs
McKesson Labs”
Parmed Pharm.
Byk-Golden
Ambix Labs
Rugby Labs!

Penta Products
Purepac — — —

Life Labs

Miles Pharm.

Owen Labs

Parke-Davis

Lemmon

Ambix Labs, Pharma Derm
or Clay Park Labs

Life Labs or Pharma Derm
Pfizer Pharm.

Rugby Labs
Stayner Corp.

product.

Barr Labs

Bolar Pharm. or Par Pharm.
Bolar Pharm.

Ives Labs

Cord Labs

Rugby Labs!

or Chelsea Labs

Cord Labs

Danbury Pharmacal

Bolar Pharm., Zenith Labs,
Barr Labs or Par Pharm.
Barr Labs

Purepac, Bolar Pharm.

or Cord Labs

Chelsea Labs

Barr Labs

or Cord Labs (40 mg)

Towne, Paulsen & Co.— — — — Cord Labs

* No response was received from this company. The information
listed has been taken from previous articles.

1 See the Rugby listing to determine the manufacturer of this

THE MARYLAND PHARMACIST

Vangard Labs* — — — — — — — Zenith Labs

VVGS (EVV AC gue ee West-Ward

Wolins Pharmacal* — —- - — — Zenith Labs,
Danbury Pharmacal
or Barr Labs

Lithium Carbonate tabs or caps

NICS hain se Pfizer Pharm.
Peniaie(OOUC(S= ear Philips Roxane
PAM Tacs. <) Sse SS = Pfizer Pharm.
Flnifers tekep¢:tals) = = = = SS Philips Roxane
ROWS ea Sa ee Rowell Labs
Stayner Corp. - — ~— — - - — Philips Roxane
Meclizine HCI 12.5 and 25 mg tabs

TiracenciltabS ae ran Par Pharm. or Cord Labs
Coast Labs == — Cord Labs or Camaill Co.
Geneva Generics — - — — — — Cord Labs
Lépleeikelyy = sae = Sas Rugby Labs!

or Chelsea Labs
LeoiyWbikkles= ==> sa — Cord Labs
McKesson) Labs> == = = = — Richlyn Labs
Psrmeciehant Bolar Pharm..,

Zenith Labs or Par Pharm.
Ponta cLOUUClS ttt Par Pharm.
OWIGENe -= Sse soe se Cord Labs or Camall Co.
Riley (keys == sa SaaS Chelsea Labs
StaynelmGOlp =a ane nes Camall Co.
Towne, Paulsen & Co.— — — — Generic Pharm.

or Danbury Pharmacal
Vangard Labs* - - - - - - - Camall Co.
West-Waldme === West-Ward
Wolins Pharmacal* -— - — - — Camall Co., Zenith Labs

or Generic Pharm.
Meprobamate 200 and. 400 mg tabs

Barr Labs — — — —- —- —- -—- - —- Barr Labs
nilat (hie (eles = Sa eee Zenith Labs or Cord Labs
OAS aS et Cord Labs
Drummer Labs — — — — — — — Lemmon
Geneva Generics — - — - — - Cord Labs
IGNiehann) ee ICN Pharm.
Ladco Labs - - - —----- Rugby Labs!

or Chelsea Labs
Lederle Labs — — -— - - —- - — Barr Labs

or Lederle Labs
Lemmon— —- -—- - - —----- Lemmon
McKesson Labs* — —- —- — - — McKesson Labs
Parke-Davis — — — — — — — — Parke-Davis
Parmed Pharm.-— - — - — - - Barr Labs, Richlyn Labs,

Zenith Labs or Cord Labs

Penta Products— - —- -— - - - Barr Labs
Philips Roxane — -— - - — — - Philips Roxane
Purepac —- - - - - ----- Purepac
Rexall Drug Co. - - - - - - Towne, Paulsen & Ca.
Rugby Labs —- - - ----- Cheitsea Labs
Smith Kline & French — — — — Smith Kline & French
Stayner Corp. - - ----- Barr Labs
Towne, Paulsen & Co.- — — — Towne, Paulsen & Co.
Vangard Labs* — — — - - - — Generic Pharm.
Wallace Labs— - - - - - - - Carter-Wallace
West-Ward* -— - - - - --- West-Ward
Wolins Pharmacal* — - —- —- — Blue Cross Products,

Zenith Labs, Generic Pharm.

or Danbury Pharmacal

Wyeth Labs - - - —----- Wyeth Labs
Methenamine Mandelate 0.5 and 1 gm tabs

H.R. Cenci Labs - — - - - - Tablicaps

Coast Labs — — — —- —- —- - = Cord Labs or Tablicaps

Geneva Generics — — - - - - Cord Labs

Invenex Pharm.* --- - - - - Invenex Pharm.

Ladco Labs - - ------ Rugby Labs!

or Heather Drug Co.
McKesson Labs®* —- —- —- - — —- Cord Labs

* No response was received from this company. The information

listed has been taken from previous articles,

1 See the Rugby listing to determine the manufacturer of this

product.

MARCH, 1982

Parke-WaViS ea Parke-Davis
Parmed Pharm.— — — — — — — Heather Drug Co.
Penta |Products= —— = = == Tablicaps
Rugby Labs —- — —- —- —-— = — Tablicaps
SER AGege) SS SaaS Chromalloy Pharm.
Vangard Labs* — - — — — - — Heather Drug Co.
West-Ward* - ~- ------— Standard Pharm.
Wolins Pharmacal* -— — — — - Heather Drug Co.
or Tablicaps
Nicotinic Acid 50 and 100 mg tabs
Abbott Labs - - - -----— Abbott Labs
HRe CenciLabs ——— — — — West Coast Labs
Coast'Labs -—— — — — = — = West Coast Labs
ICN Pharma ICN Pharm.
EW Lilly’ &:Co. Eli Lilly & Co.
McKesson Labs* — — —- —- - — McKesson Labs
Parke-Davis -— - — - - - —- - Parke-Davis
Philips Roxane — - -— - - - - Philips Roxane
Rugby Labs - - - - ~ - - - Chetsea Labs
Smith Kline & French -— -— — — Philips Roxane
_ E.R. Squibb & Sons-— - - - - E.R. Squibb & Sons
Stayner Corp. - - --- - - Stayner Corp.
Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.
Vangard Labs* - - - - - - - Generic Pharm.
West-Ward* —- - — - - - — - West-Ward
Wolins Pharmacal* — - — — — Generic Pharm.
Nitrofurantoin 50 and 100 mg tabs or caps
nda Gepreli (hele) = 2 oe Se Botar Pharm.
Geneva Generics — - — — —- — Bolar Pharm. or Zenith Labs
Ladco Labs’ - — - —- —- - - - Rugby Labs"
McKesson Labs* —- —- —- — — — Pierrel America
Nofwich-Eatoni se Eaton Labs, Inc.
Parmed Phat. Bolar Pharm.
PentalrroductS=——s————s—n— Bolar Pharm.
WPS = sass ae aes Ketchum Labs
or Bolar Pharm.
Rugby Labs — — - — —- — — — Chelsea Labs
StaynenCorpye Bolar Pharm.
Towne, Paulsen-& Co.— - — — Ketchum Labs
Viangard PabSne sata Ketchum Labs (tabs)
. Bolar Pharm. (caps)
VViCSt2VV al Cee Ketchum Labs
Wolins Pharmacal® — - —- - - Bolar Pharm. or Zenith Labs
Nystatin oral tabs, suspension and vaginal tabs
Parmed Pharm.- —- — — —- - — Premo Pharm.
Rugby abs Chelsea Labs
E.R. Squibb & Sons— —- - - - E.R. Squibb & Sons
Wolins Pharmacal* — — — — — Premo Pharm.
Papaverine HCI 150 mg caps
Hina Genci labsm———s nt Generic Pharm.
Central Pharm. — - - - — - -— Central Pharm.
Coastitabsme— se Cord Labs or Phoenix Labs
’ Geneva Generics — - —- - - - Cord Labs
ICNIPRa ee ICN Pharm.
Ladco Labs - — - - - - - - Rugby Labs!
or Chelsea Labs
Lederle Labs —- - - - - - - - Mylan Pharm.
Lemmon- — - —- - —----- Danbury Pharmacal
Marion Labs — — — — — ~ — — Marian Labs
McKesson Labs” — —- - —- — - Cord Labs
Parke-Davis — —- — — — — — — ‘Marion Labs
Parmed Pharm.— — — — — — — Inwood Labs,

Heather Drug Co.
Zenith Labs or Premo Pharm.

Penta Products— — — -— — - - Generics

Philips Roxane — — - —- — — - Cord Labs

Purepac - - - ------- Purepac

Rugby Labs - - - - - - - - Chelsea Labs

Stayner Corp. - - - - - - - Cord Labs

Towne, Paulsen & Co.— — — — Mylan Pharm. or Cord Labs
Vangard Labs* —- - —- - —- - - Danbury Pharmacal
West-Ward* - - ------ Danbury Pharmacal

Wolins Pharmacal* -— —- —- - — Chromalloy Pharm.

or Zanith Labs

Continued in April

af

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

AMINOGLUTETHIMIDE:

Twenty years ago aminoglutethimide was utilized as
an anticonvulsant. It was withdrawn from the market
because it caused adrenal insufficiency and hypothy-
roidism. The drug blocks the conversion of choles-
terol to steroidal products normally synthesized by
the adrenal gland. Because of this activity, it was used
in patients with excessive adrenal activity, e.g. Cush-
ings disease. It is very effective especially when com-
bined with radiation therapy. Med Lett Drugs Ther,
VOle235 lO pelos ie

HEROIN:

Cancer patients were given injections of either mor-
phine or heroin to control pain. After a period of time,
each patient received the other analgesic in a cross-over
fashion. Although heroin was more potent than mor-
phine, at equianalgesic doses there was no difference in
their effectiveness or toxicity. NENGJ MED, Vol. 304,
OND el SU LeLos ke

SALICYLATE ABSORPTION:

A commonly used over-the-counter antidiarrheal
preparation, Pepto-Bismol, contains bismuth sub-
salicylate as an active ingredient. When ingested on an
empty stomach, salicylate levels capable of producing
toxicity can be found in the plasma. It is suggested that
patients using this preparation chronically be advised to
watch for possible development of signs of salicylate
intoxication. CLIN PHARM, Vol. 29, #6, p. 788, 1981.

BENDECTIN:

For many years, people have studied the associa-
tion between the anti-nauseant drug Bendectin and birth
defects. Until 1976, Bendectin contained doxylamine
succinate, dicyclomine hydrochloride and pyridoxine
hydrochloride. Dicyclomine was removed from the
formulation after that date and in 1978 approximately 3
million prescriptions were written for the drug. Infor-
mation gathered between 1968 and 1978 was evaluated
and the authors of this paper have failed to find a corre-
lation between the product and birth defects. As is the
case with all drugs used during pregnancy, the potential
value of the agent used should be weighed against the
possible adverse reactions before it is prescribed. J AM
MED A Vol. 245, #22, p. 2311, 1981.

PROPRANOLOL-CIMETIDINE INTERACTION:
Propranolol (Inderal) was administered to patients
and blood levels were determined. Cimetidine (Taga-
met) was then added to the regimen and it was noted
that the plasma levels of the beta-adrenergic blocking

28

agent were significantly elevated. It is concluded that
cimetidine reduces the first-pass hepatic extraction of
propranolol and thus allows for more of the drug to gain
access to the blood stream as the active compound.
BR MED J, Vol. 282, #6280, p. 1917, 1981.

BENZODIAZEPINE ANTAGONIST:

A new drug has been synthesized which has the
ability to reverse the effects produced by the ben-
zodiazepine derivatives, e.g. diazepam (Valium), chlor-
diazepoxide (Librium). The new agent is thought to be
valuable in reversing signs of toxicity produced by these
depressants and may also be useful in helping to deter-
mine the mechanism of action of such agents. Currently
it is thought that benzodiazepine derivatives act on a
specific receptor which in turn results in facilitation of
the inhibitory effects produced by gamma amino butyric
acid. LANCET, Vol. II, #8236, p. 8, 1981.

QUINIDINE-RIFAMPIN INTERACTION:

Plasma levels of quinidine were monitored in pa-
tients receiving rifampin and in a control population
group. Since rifampin, an anti-tubercular agent, has
been identified as a potent hepatic microsomal enzyme
inducer, it was not surprising to find that the plasma
levels of the antiarrhythmic agent were significantly
lower when rifampin was added to the regimen. N ENG
J MED, Vol. 304, #24, p. 1466, 1981.

TOLUIDINE BLUE:

A new method of detecting squamous carcinoma of
the oral cavity has been devised using toluidine blue
dye. The substance is used as a mouth rinse and selec-
tively stains the abnormal tissue. The diagnostic tech-
nique can detect problems which might not be seen
during a routine oral examination. J AM MED A, Vol.
245, #23, p. 2408, 1981.

ANTIBIOTIC-ASSOCIATED COLITIS:

Clostridium difficili and its toxin were first as-
sociated with antibiotic-induced colitis in 1978. Since
that time various treatments have been utilized, but
vancomycin, given orally in doses of 125 mg every 6
hours for 5 days, seems to best control the organism.
Elderly patients are more susceptible to the infection.
Approximately 80% of the reports of this type of colitis
implicate clindamycin and lincomycin, but it was also
seen in patients who have received ampicillin, tetracy-
cline, chloramphenicol, cephalosporins, penicillins, co-
trimoxazole, and metronidazole. BR MED J, Vol. 282,
#6280, p. 1913, 1981.

THE MARYLAND PHARMACIST

DOXPICOMINE:

A new analgesic was compared with morphine in
postoperative patients. The drug, doxpicomine, was as
effective as morphine in relieving this type of pain. The
drug is chemically different from the opiates, but seems
to work in a manner identical to them. The drug may not
be as likely to cause physical addiction as morphine.
CLIN PHARM, Vol. 29, #6, p. 771, 1981.

LEGIONELLA:

Since the discovery of Legionella pneumophilia,
several other forms of the organism have been isolated.
The latest organism has been named Legionella mic-
dadei (L. pittsburgenesis). L. bozemanii, L. dumoffi,
and L. longbeachae are all Gram negative organisms
and the infections caused by these respond well to the
administration of erythromycin. ANN INT MED, Vol.
94, #6, p. 739, 1981.

CLODRONATE:

Clodronate disodium is an agent found to be effec-
tive in reducing osteoclastic bone resorption in animals
and in patients with Pagets disease. The drug is used

intravenously and is excreted primarily unchanged in
the urine. CLIN PHARM, Vol. 30, #1, p. 114, 1981.

FERTILITY:

Women who are planning to have children in the
future but who do not wish to conceive now are more
likely to become pregnant later if they use oral con-
traceptive preparations rather than intrauterine devices.
A study shows that future fertility may be altered if the
IUD produces tubal damage and thus oral medication is
recommended for women who ultimately want to plan a
family. LANCET, Vol. I, #8234, p. 1329, 1981.

EMETICS:

Generally syrup of ipecac is used to induce vomit-
ing, but it takes approximately 15 to 20 minutes to work.
In addition, many households do not have the prepara-
tion on hand, and alternate methods of inducing vomit-
ing need to be used. Mechanical induction of emesis 1s
often ineffective and the use of sodium chloride solu-
tions can be dangerous and has actually caused death.
When no alternate means of inducing vomiting was
available, patients were given dish washing detergent in
solution. These worked quite well, but pre-school chil-
dren tend to refuse to drink the solution. The products
used included Ivory, Dove and Palmolive liquids. CLIN
LOXIGRN Ola S a 34 D211, 198

LEGIONNAIRES DISEASE:

Five years ago the term Legionnaires disease was
coined to describe symptoms produced by an organism
ultimately named Legionella pneumophilia. Today
there are known to exist at least six serotypes of four
newly recognized related organisms. Thus, the disease
may be more common than thought. Patients complain

MARCH, 1982

of fever, malaise, chills and headache. Some coughing
may be present and vomiting and diarrhea with abdomi-
nal pain is usually present. Temperatures are often
above 102 degrees F and bradycardia may also be pres-
ent. AM FAM PHYS, p. 165, July, 1981.

NITROGLYCERIN:

Patients with asthma were given sublingual nitro-
glycerin in efforts to determine if the smooth muscle
relaxant might be beneficial in treating this respiratory
disease. The drug did not seem to be effective and
hypotension was seen after adminstration of the 1.2 mg
dose. J AM MED A, Vol. 246, #2, p. 145, 1981.

MIGRAINE HEADACHE:

A new hypothesis has been presented to help ex-
plain the sequence of vasoconstriction and vasodilation
associated with the migraine headache attack. It is
suggested that the initial phase of vasoconstriction may
be caused by a variety of substances or reactions, but
that the net result is reduced blood flow and hypoxia.
This is followed by reactive hyperemia or increased
blood flow to the area. ATP and its breakdown products
have been found in high concentration in the cerebro-
spinal fluid of patients during an attack, and the authors
suggest that it is the ATP and its metabolites which
cause the pain and dilation associated with the migraine
attack. He further suggests that some analogs of ATP
may have beneficial effects on migraine headaches.
LANCET, Vol. II, #8235, p. 1397, 1981.

AQUAGENIC PRURITUS:

Certain people complain of itching when their skin
comes in contact with water. Some of these individuals
have been considered to be somewhat mentally unstable
because there seems to be no obvious pathological
damage or evidence of a reaction. Work in Great Britain
has offered an explanation for this phenomenon. It ap-
pears that water can cause the release of acetylcholine
in the skin of some patients, and in addition it appears
that mast cells tend to degranulate during the attack.
Further research shows that the plasma concentration
of histamine is elevated during these attacks. It is
suggested that patients with this type of aquagenic
pruritus be treated with antihistamines to help prevent
symptoms. BR MED J, Vol. 282, #6281, p. 2008, 1981.

ISOFLURANE:

Isoflurane is a non-flammable halogenated general
anesthetic agent which is administered via the inhala-
tion route. Although it has characteristics similar to
those of halothane and enflurane, it produces more
skeletal muscle relaxation than halothane and it does
not have the central nervous system irritant effects of
enflurane. Isoflurane is not extensively metabolized as
are the other agents and it does not sensitize the myo-
cardium to the effects of catecholamines. J AM MED A,
Vole24Ase 2 02550, 1981.

29

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service for members. | 980”

Our first annual reunion will be on Sunday, July 11,
Be Sure To Have Off!

FOR SALE:
VENDING MACHINES: (3) Like new. Hot food, hot drinks, and Repeat performances from:
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AND MORE

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CENTENNIAL MARKET 465-7295

*Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about

this certificate. ERRATA
* Special offer. A Mounting and display kit available The 1963 President of the M.Ph.A. was William A.
from the Association for displaying your Centennial Cooley. We regret the error in the January issue.

Certificate. $15.00 each from the Association office.

* The M.Ph.A. is offering to the public and its members
the USP publication, ‘“About your Medicine.” This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from ORDER YOUR PHARMACY
the Association office. Also available—‘‘About your *

High Blood Pressure Medicine’ —$3.00 each plus $1.00 Pelt ede
postage and handling.

*The Pharmacy Art Print ““Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

* Centennial Apothecary Jars with the Association’s
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

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MARCH, 1982 af

Patient
Education

Expanding Pharmacists’ Role

Call it what you will, there’s no denying the fact
that we are in the midst of a revolution of sorts in this
country. Patients are no longer content to accept
blindly some vague directions typed on the prescrip-
tion label; they are refusing to sit still for the “father
knows best’’ attitude of many health care
professionals.

The 1982 Annual Meeting of the American Phar-
maceutical Association focuses on pharmacy’s
“rebirth” in patient education.

The 1982 program—set for April 24-29 in Las
Vegas, Nevada, — features presentations on a range of
patient-oriented topics by top speakers in health,
medicine, and politics, including the current FDA
Commissioner Dr. Arthur Hull Hayes, Jr.

The program also will provide practical, “how to”
workshops planned to help practitioners understand
how to handle special or unique problems in patient
communications, as well as day-to-day interactions.
Registrants will also see and test specially designed
patient education tools and methods.

Please rush to me the following items
for the 1982 APhA Annual Meeting:

e Advance Registration Form Name

@ Hotel Reservation Form Address

e Air Fare Savings to Las Vegas City

e@ Optional Tours and Activities State

129th Annual Meeting
American Pharmaceutical Association

Las Vegas
April 24-29,1982

All this plus...

Continuing Education Credit: Registered partici-
pants can obtain a maximum of 30 contact hours (3.0
c.e.u.) of continuing education credit at the 1982
APhA Annual Meeting in Las Vegas.

Tax Deduction for Educational Expenses: Treasu-
ry regulation 1.162-5 permits an income tax deduc-
tion for educational expenses (registration fee and
cost of travel, meals and lodging) undertaken to: (1)
maintain or improve skills required in one’s employ-
ment or other trade or business, or (2) meet express
requirements of an employer or a law imposed as a
condition to retention of employment, job status or
rate of compensation.

Clip coupon below and mail today to:

APhA ‘82
2215 Constitution Ave., NW
Washington, DC 20037
..or telephone (202) 628-4411

THE
MARYLAND
PHARMACIST

Official Journal of
The Maryland
Pharmaceutical

Association

April, 1982
VOL. 58
NO. 4

Fornuition of ie Menyland State
Pharmaceutical Association — ;

Manufacturer Disclosure

A Brief History of USPHS $ Pharmacy
in Mamie a a

= — George F. Archambault Ls

Celebrate the Centennial
M.Ph.A. Annual Convention June 20-24, 1982

Carousel Hotel, Ocean City, Maryland
Watch for details

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 Nae

APRIL, 1982 VOL. 58 NO. 4

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor
CONTENTS ABRIAN BLOOM, Photographer

; 9 Officers and Board of Trustees
President’s Message res

; Honorary President ;
4 Formation of the Maryland State Pharmaceutical JOHN C. KRANTZ, JR., Ph.D. — Gibson Island

ceatd President
Association — B. F. Allen, Ph.D. BHILIE ECOCANEE TERT
President-Elect
10 Manufacturer Disclosure MILTON SAPPE, P.D. — Baltimore
Vice-President
IRVIN KAMENTZ, P.D. — Baltimore

Treasurer

MELVIN RUBIN, P.D. — Baltimore
20 A Brief History of USPHS Pharmacy in Maryland Executive Director

DAVID BANTA, M.A. — Baltimore
ae George F. Archambault Executive Director Emeritus

NATHAN GRUZ, P.D. — Baltimore

18 Return Goods Model Form

27 Pictures

TRUSTEES

SAMUEL LICHTER, P.D. — Chairman
28 Abstracts Randallstown

WILLIAM C. HILL, P.D. (1984)

Easton
DEPARTMENTS GEORGE C. VOXAKIS, P.D. (1984)

Baltimore

BARBARA BARRON, P.D. (1983)

7 Calendar Rising Sun, Maryland
STANTON BROWN, P.D. (1982)
Silver Spring

31 Classified Ads RONALD SANFORD, P.D. (1982)
Catonsville

>Guellcteretontheseditor DUDLEY DEMAREST, SAPhA (1982)
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EX-OFFICIO MEMBER
WILLIAM J. KINNARD JR., Ph.D. — Baltimore

ADVERTISERS
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8 The Drug House 9 Pfizer MADELINE FEINBERG, P.D. — Kensington
30 Eli Lilly and Co. 17 Upjohn Vice Speaker

JAMES TERBORG, P.D. — Aberdeen

16 Loewy Drug Co.

MARYLAND BOARD OF PHARMACY
Honorary President

Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN, P.D. — Salisbury
new address with zip code number. Allow four weeks for changeover. APhA member — .
please include APhA number. caesar

BERNARD B. LACHMAN, P.D. — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore
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land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201.

PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

2 THE MARYLAND PHARMACIST

APRIL, 1982

President's Message

Why is it that so many outsiders are trying to legislate standards of
practice for pharmacy? At the federal and state levels, bills have been intro-
duced to require all practicing pharmacists to do what the profession has advo-
cated for years. At this writing, none of the bills I am referring to have been
passed. But consider the patient package insert argument. If we all routinely
consulted with our patients, the issue would be moot. It is my understanding
that five states have already passed legislation that will require consultation. In
order to help us consult better, there is mandatory continuing education. Don’t
forget the mandatory patient profiles, etc.

The objective of all these requirements are worthy, but do they have to
be mandated? Maybe so, if pharmacists do not respond on their own. I person-
ally feel that we are moving in the right direction. Obviously, we are not moving
quite fast enough to please everyone. Twenty years ago, who heard of patient
profiles for pharmacies? Similarly, twenty years ago, it was very controversial
to even let the patient know the name of the drug dispensed, let alone its
pharmacological action. I can remember when good continuing education
courses were few and far between. Now they are pervasive, although there is
still room for more continuing education presentations in the non-metropolitan
areas.

I agree with the principles behind the standards that will upgrade our
profession, but I think they should be implemented voluntarily. What good is a
patient profile when the overwhelming majority of patients in a particular prac-
tice are transient? If the pharmacist doesn’t keep the profiles up-to-date or even
neglects to use them regularly, who do they help? How much will a pharmacist
learn in a continuing education course if he is forced to attend classes and
chooses not to pay attention?

Legislation is not the answer. The answer must come from pharmacists
motivating pharmacists to do what is right on their own volition.

Philip H. Cogan,

President

The Centennial Committee

Formation of the
Maryland State

MARYLAND
PHARMACEUTICAL
ASSOCIATION

Pharmaceutical Association

by B. F. Allen, Ph.D.

In 1882, the old Maryland College of Pharmacy gave
birth to the State Association. At a Meeting of the Col-
lege on October Sth, a statement was made that there
was no organization in the State for the mutal protection
of Pharmacists, and wholesale and manufacturing drug-
gists. Therefore, the use of the College Building (east
side of Aisquith Street, two doors north of Fayette
Street, nine blocks directly east of City Hall) was of-
fered as a place of meeting and twenty-five dollars au-
thorized to defray the expenses.! (Note: the first state
association—Maine—was founded on July 23, 18677).

Also, at this meeting the Maryland College of Phar-
macy President (Joseph Roberts, Manufacturing
Chemist and Pharmacist, No. 1 Greenmount Avenue)
offered a series of resolutions in regard to the formation
of the Association and a fifteen member committee to
be appointed. The following served on this Committee:
Charles Caspari, Jr. (Professor of theory and practice of
Pharmacy), Louis Dohme (Sharp and Dohme, south-
west corner Pratt and Howard Streets), Edwin
Eareckson (Pharmacy College Secretary, northeast
corner Baltimore and High Streets), Columbus Emich
(407 North Greene Street), N. Hynson Jennings (Phar-
macy College Vice-President, 90 North Charles Street),
Robert Lautenback (northeast corner Eutaw and
Saratoga Streets), Samuel Mansfield (Pharmacy College
Treasurer, southwest corner Baltimore and Schroder
Streets*), J. Faris Moore (Professor of Botany and
Materia Medica), J. E. Morrison, Joseph Roberts
(Chairman), William S. Thompson (Member of first
graduating class, Maryland College of Pharmacy 1842),
Alonzo L. Thomsen (Manufacturing Chemist, Honover
and Winder Streets), John J. Thomsen (importer of
drugs, 251 West Baltimore Street), John H. Winkel-
mann (Wholesale Druggist, 45 South Sharp Street), T.
Baird Wolf, M.D.3,4

PREAMBLE AND RESOLUTIONS

Passed at a meeting of the
MARYLAND COLLEGE OF PHARMACY
Held October 5, 1882.

“This Pharmacy Building (two and a half stories high) still stands
today.

4

WHEREAS, The general progress and well-being of our pro-
fession demand that the Pharmacists everywhere be
thoroughly organized, and

WHEREAS, The business relations existing between Phar-
macists and Wholesale and Manufacturing Druggists are and
ought to be of the most intimate and confidential character,
and

WHEREAS, The Pharmacists, the Wholesale, and the Man-
ufacturing Druggists have thus far had no organization in this
State for their mutual protection, benefit, and the general ad-
vancement of pharmaceutical interests and knowledge:

THEREFORE, BE IT RESOLVED, That a committee of fif-
teen be appointed to correspond with and invite every Phar-
macist, Wholesale and Manufacturing Druggist in the State to
meet in the city of Baltimore on the second Tuesday of May
next, to organize an association for the purpose set forth in the
preamble.

BE IT FURTHER RESOLVED, That the said committee be
and are hereby instructed to draft a suitable Constitution and
By-Laws, to be submitted to the proposed association for their
consideration, and that they do such other work as will, in
their judgment, be useful to, and facilitate the speedy organi-
zation of the said proposed association.

BE IT FURTHER RESOLVED, That we cordially tender to
the Pharmacists, the Wholesale and Manufacturing Druggists
of the State the use of the College Building as a place of
meeting.

The invitation to attend the meeting on the second
Tuesday next (1883) was dated as of November 12, 1882
and carried the names of fifteen-member committee and
Joseph Roberts or Charles Caspari, Jr. (Baltimore and
Fremont Streets”) as the Sub-Committee on Corre-
spondence.°®

Baltimore, November 12, 1882

Dear Sir:

The undersigned Committee, acting in behalf of the Mary-
land College of Pharmacy, cordially invite you to meet in the
city of Baltimore on the second Tuesday of May next at 11
o'clock A.M. at the hall of said College, for the purpose of
organizing an Association of the Pharmacists, the Chemists,

» Caspari’s Drug Store at this location was on the northwest corner
of Baltimore Street and Fremont Avenue. This building (three stories
high) still stands today. Charles Caspari, Jr. became Dean at the
Pharmacy College in 1896.

THE MARYLAND PHARMACIST

the Wholesale and Manufacturing Druggists of the State, for
the general advancement of the science of Pharmacy, and the
promotion of mutual interests.

Be kind enough to advice the Committee if they may count
upon your presence and hearty co-operation.

Edward Eareckson
Charles Caspari, Jr.
J. Faris Moore

C. V. Emich
Samuel Mansfield
Alonzo L. Thomsen
R. Lautenbach

S. B. Wolfe

John J. Thomsen
Joseph Roberts

J. E. Morrison

Louis Dohme

John H. Winkelmann
W.S. Thompson

N. H. Jennings

Address:
JOS. ROBERTS, No. 1 Greenmount Avenue,
or Chas. Caspari, Jr., Baltimore and Fremont Streets
Sub-Committee on Correspondence.

Your attention is respectfully called to a series of resolutions,
under authority of which this call is issued.

In response to the call issued, twenty-five apothe-
caries (druggists and pharmacists) assembled at the Ha!l
of the Maryland College of Pharmacy on Tuesday,
May 8, 1883. Joseph Roberts called those present to
order and on motion, Edwin Eareckson was elected
as temporary Chairman with Charles Caspari, Jr. as
Secretary Pro Tem. Roberts offered a resolution
announcing those present as organized into a Maryland
State Pharmaceutical Association, and moved the ap-
pointment of a committee to nominate permanent offi-
cers and to present a draft of a Constitution and By-
Laws. Both resolutions were adopted.’

The Chair appointed the following committee for the
purpose: from Baltimore, Joseph Roberts, Louis
Dohme, and A. J. Corning; Levin D. Collier of Salis-
bury, and Hugh Duffy of Hillsboro. This Committee
nominated the following gentlemen as permanent offi-
cers (and they were elected)*: President—John J.
Thomsen (Baltimore), First Vice-President—C. W.
Crawford (Gaithersburg), Second Vice-President—
Thomas W. Shryer (Cumberland), Third Vice-Presi-
dent—Hugh Duffy (Hillsboro, Caroline County), Sec-
retary—John W. Geiger (Baltimore), Treasurer—E.
Walton Russell (Baltimore); Members of the Executive
Committee—Samuel Mansfield (Baltimore), Joseph B.
Boyle (Westminister), Henry A. Elliott® (Baltimore).

Joseph Roberts read a draft of the Constitution,
which after being amended, was on motion of David
M.R. Culbreth®? (Ph.G., Maryland College of Phar-
macy, 1879; M.D., College of Physicians and Surgeons,
Baltimore, 1883) adopted as a whole. The newly elected

©In January, 1853, Mr. Elliott opened a drug store on the south-
east corner of Lexington and Pine Streets. He carried this on suc-
cessfully for fifty years.? In 1886, a Maryland College of Pharmacy
Committee (Thomsen, Elliott, Eareckson, Roberts) was appointed to
investigate the advantages of various sites for the erection of a new
Pharmacy College Building. After examining several sites, the Com-
mittee was extremely interested in a lot on the northside of Lexington
Street just west of Pine Street.'° Both of these locations are near the
new University of Maryland School of Pharmacy, Northwest corner
of Baltimore and Pine Streets.

4Dr. Gulbreth conducted a retail pharmacy at the northwest
corner of Charles and Eager Streets for fifteen years.

APRIL, 1982

President Thomsen was introduced (by the retiring
Chairman) and delivered a prepared address."!

At the afternoon session on May 8th, the President
appointed the following as members of the various
committees—Legislation (Roberts, Hassencamp,
Crawford, Moore, Eareckson), Pharmacy (Caspari,
Louis Dohme, Shryer, Boyle, Thompson), Trade Inter-
ests (Alonzo L. Thomsen, Charles E. Dohme, Roberts,
Duffy, Emich), Business (Mansfield, Geiger, Culbreth,
Collier, Corning). !?

It was also decided to enroll as members of this
Association all reputable pharmacists and druggists who
shall send in their names accompanied by the initiation
fee and first year’s dues on or before June 15, 1883.

The new Association Secretary, therefore, sent out
the following letter:

MARYLAND STATE
PHARMACEUTICAL ASSOCIATION

Tess eK ae se SK os eK

Baltimore, May 12, 1883
Dear Sir:

Pursuant to a call, anumber of Pharmacists, Druggists and
Chemists of this State met in Baltimore on the 8th of this
month, and organized themselves into the MARYLAND
STATE PHARMACEUTICAL ASSOCIATION.

As it is desirable that every reputable Pharmacist of this
State should become a member it was unanimously resolved
to admit every Pharmacist and Druggist in good standing as a
member, and enroll him as such after signing and sending in by
mail enclosed application to the Treasurer, accompanied by
three dollars, to pay the initiation fee and first year’s dues;
provided your application reaches the Treasurer On or before
June 15th.

You are earnestly requested to join the Association.

Respectfully,

JOHN W. GEIGER,
Secretary

Before adjournment, delegates were elected to the
following Associations: American Pharmaceutical
Association—Louis Dohme, J. Faris Moore, John W.
Geiger, Thomas W. Shryer, C. W. Crawford; National
Association of Retail Druggists—Joseph Roberts,
Charles Caspari, Jr., Edwin Eareckson, Samuel Mans-
field; Virginia Pharmaceutical Association—Charles
Caspari, Jr., J. Faris Moore, Herman I. Thomsen.

Members of the
Maryland State Pharmaceutical Association

1882 —1883
ADCETSONU a GEO wie Pineiro ds oheye weak «6 Port Deposit, Md.
Betise RAGA mee Sia Rate oe kore rere ccracora is oa Baltimore, Md.
Blane yy bee Mi en nee Si rae aries eos 2m Baltimore, Md.
Boyles Jo Bae pt et et sl Shes be Ss 9 Westminster, Md.
Burrough > Onc cent te ann oe ees Baltimore, Md.
CampbelleaWe be wtemate ee tea noe Was 6 2 ate iy: « Cumberland, Md.
Caspart® Chastlr sister or cos). oe git wate oe Baltimore, Md.
Chishoim,. Dans l eevee in. Sree aieiae!..s oes co Oakland, Md.
Colhiert Drstevinal re eee trad cite oct as dass Salisbury, Md.

COPS AC) «cc Hees «5 eats oe te ee Baltimore, Md.
Coskery, He J.. 0220.0. 2. te oe ee Catonsville, Md.
Crawford) GoW: «|. . ¢< sae sol ota eee Gaithersburg, Md.
Daviess D2 © wien wee tree cin» ocala eee eT Baltimore, Md.
Dickinson, Jas.-A. «3.4 .<:66%. eee Baltimore, Md.
Dohme, [Louis vse cs. 6 6 eee eee Baltimore, Md.
Dodson 1G. Marion .44-e oe eee eee Baltimore, Md.
Duffy, Hugh 40) 2.02 = A eaters Hillsboro, Md.
Bareckson, Edwin s2.0s.24-- ree eee Baltimore, Md.
EdwardSssWm shee oh ere Baltimore, Md.
Elhiott4Henry: Ao\...% 3740s oe eee eee Baltimore, Md.
Bly; Wms Ricgzts baals faces as et une een mea Baltimore, Md.
Emerson: [saactEha ec ee eae Baltimore, Md.
Emich. CAvVe 23. ee eee eee Baltimore, Md.
Foster..Ja WebbJin ato eee Baltimore, Md.
Geiger, John: W oc sade carat ee eee Baltimore, Md.
Geoghegan, JuiR., Jc 2ikeuc. sae eee Baltimore, Md.
Grote. -Prancis: Ji: esto oe eee Baltimore, Md.
Flassencamps Fi. ace oe eer Baltimore, Md.
Hayward. Thomas) So aances. eee eee Easton, Md.
Henry, J Co ote are ee ee Orr meee et tere Easton, Md.
Heinzé? Otto‘BS Gees aes Baltimore, Md.
Hermann: JS. Giese see err ee Cumberland, Md.
Horii: Les Ghai ee et Re eee Baltimore, Md.
Horstmann Henty Raer aoe ee Baltimore, Md.
Jennings AN PH etree nels cect ee eee Baltimore, Md.
Keller (Wa lay eee oe ee ee eee Baltimore, Md.
Kemp; Re Fee ae eee) fe ae etn eens Trappe, Md.
Lanéyy Hate eee eee ae ee Cumberland, Md.
Leary, JR Actes ete ae eee eee Rock Hall, Md.
Mangers Jao). cet rites acest eee ee Baltimore, Md.
MansfieldSamuUclitge sence eee Baltimore, Md.
Merricks<WiitS.ne seed virie cate Oh otis ae oe eae Trappe, Md.
Moores SC ae seer eee eee Baltimore, Md.
Moores JR Barist eee eee Lea eee Baltimore, Md.
Muth: Geo lia eer eer ere Baltimore, Md.
Muth? John Paar anne ee ee Baltimore, Md.
Mutha MS OSep iets ete cre ies ree eenier Baltimore, Md.
Myers: Josepitees hrc oe eee eae Lonaconing, Md.
Nevill 7 WAR aire eee oe ree Woodberry, Md.
Passapder. Chas. D ya eee eee ee Baltimore, Md.
Pilson> ‘Aci O sac eee nels ei Bled ede eigenen Baltimore, Md.
Pue. Chas? Rane e eee eer ect arene ee Baltimore, Md.
R@leeiais., UOSefoln IDs oocosoccaundae000n000€ Baltimore, Md.
Russells bes Waltons err ree ei Baltimore, Md.
SCHIOCIEE A HENLY -) were tata. eee ner Baltimore, Md.
Scorader” A UCUS te tte Star eee ee Baltimore, Md.
AIAG ANGELS AWS, Comec.) okie dels Bos oG.ccrwe-ot Cumberland, Md.
Smmon Props Wee ere ee eee Baltimore, Md.
Smmithit le. Wisk an eek oe 3 es ae eins Shee ee Ridgely, Md.
Stam #Golinth. aa a eee eee Chestertown, Md.
Stehl 2 Justtisy Vicente eee ee eee ee Baltimore, Md.
steiner Henry Rieko eee eee Frederick, Md.
Stewart, 2 VD eee ee eee Baltimore, Md.
ihomsenAlonZo} ae eee ee eee Baltimore, Md.
Theyre, SKIT Is aac ccckooasooobooanoue Baltimore, Md.
Thomsen John leno. eee eee Baltimore, Md.
Thomsen sie) Treen fe one ee a eee Baltimore, Md.
hOMpSONss Wis S Ber oie ee eee eee eee Baltimore, Md.
Truitt; GEOR wavcute ee ee eee Salisbury, Md.
PLLC Cae UL US9 Koka oti niees eed eee ee ee oe Salisbury, Md.
Webb=JohnivAce cee cerca ne real ne ee: Baltimore, Md.
WetselsTobn, Ma. 3 Se ene ea eee Baltimore, Md.
Winkelmanss ohn Heras. ue okie eee Baltimore, Md.

The influence of the Association steadily grew. In
1883, there were seventy-three members, in 1884,
ninety-six members, in 1885 one hundred and two
members, and one hundred and nine in 1886. The 1884
meeting was held in the Hall of the Maryland College of

6

Pharmacy (May 13-14): the 1885 meeting in the
Academy of Music, Hagerstown (May 12~—13); the 1886
meeting in the House of Delegates Chamber, State
House, Annapolis (June 1); and the 1887 meeting in
Ocean City, (Iulyel9) 228 tate

In 1904 the historical committee of the Association
(John F. Hancock, Louis Schulze, Henry P. Hynson)
reported that no published or unpublished records of the
conventions held from 1887—1892 has been found.® The
Committee reported that the meeting of 1893 was
passed and the 1894 meeting held at the Blue Mountain
House in Pen Mar was attended by a bare quorum and
little more was done than elect officers.'??°

The historical committee of 1912 (Hynson and J. F.
Hancock) reported finding additional information re-
garding lost meeting records.?!

The articles of Incorporation of the ‘*Maryland State
Pharmaceutical Association of Baltimore City’’ dated
twenty-sixth Day of November, in the year eighteen
hundred and eighty-nine bear the names of the following
as the incorporators:** D.C. Aughinbaugh, M. L.
Byers, A.J. Corning, David M. R. Culbreth, M.D.‘,
Edwin Eareckson, Columbus V. Emich, E. M. Fore-
man, Joseph P. Garrott, John W. Geiger, J. Walter
Hodges, Samuel Mansfield, William Simon’, J. Charles
Smith, and John J. Thomsen.

The Association celebrated its fiftieth birthday at the
Atlantic Hotel, Ocean City, June 21—24, 1932, The
Masters of Ceremonies called the roll of those who had
been members of the Association during its first year in
1882. No one answered present, and it was stated that of
the fifty-four men (?) constituting the membership, on-
ly one, Henry R. Steiner, Frederick, was living. Mr.
Steiner was in his eightieth year, but did not feel able to
make the trip to the Ocean resort. However, he still was
engaged in pharmaceutical work and operated his own
drug store.74

William Ross Ely (Baltimore) also a member in 1882
died several weeks before the convention. E. M. Fore-
man was presented as the one of two survivors of the
band of fourteen who incorporated the Association in
1889. Dr. D. M. R. Culbreth, the other living incor-
porator, found it impossible to attend. Mr. Foreman
(Centerville) served as President of the Association in
1890. Also present at this affair were thirteen past presi-
dents (in addition to Foreman).?5°?°

It is interesting to note the following: at a Maryland
College of Pharmacy meeting the Board of Trustees on
July 19, 1888 granted the M.S.P.A. the use of the Col-
lege building for its coming meeteing.?” On February 19,
1891, the Pharmacy College invited the members of the
State Association to join in the festivities of the fiftieth
anniversary of the College. The College Trustees also

© The 1889—1892 meetings were held in Baltimore.

‘ Professor of Botany, Materia Medica and Microscopy (Maryland
College of Pharmacy).

* Professor of General Chemistry and Analytical Chemistry
(Maryland College of Pharmacy).

THE MARYLAND PHARMACIST

granted the M.S.P.A. the use of the College Building on
Thursday, April 16, 1891.78 At a meeting of the Board
on October 15, 1891, the use of the College Building was
tendered the M.S.P.A. for its annual meeting in
November.*? A meeting of the College was held on April
18, 1895 and President John F. Hancock of the
M.S.P.A. applied for and was granted the use of the
Building during the coming meeting of that body.?° At
this thirteenth annual meeting, a reception was held in
the parlors of the Carrollton Hotel (light Street?!) on
Monday Evening, May 7th and the Association assem-
bled in Alumni Hall of the Maryland College of Phar-
macy, Tuesday, May 8th.*?

It is noted that in the early years of the Association
(MSPA), some of the officers were closely associated
with the Maryland College of Pharmacy (MCP) in a va-
riety of capacities. For example, John W. Geiger
(southeast corner Pratt and High Streets) the first Sec-
retary in 1883 (and again 1889—94) was also Secretary of
the MCP for many years (1883—95). Samuel Mansfield
Treasurer of MSPA during the period 1886—94 was
treasurer also of the College for twenty-two years
(1882—1904). Also, Edwin Eareckson President MSPA
(1885), President MCP (1888—90); William Simon
President MSPA (1887), Chemistry Professor MCP
(1871—1904); Henry A. Elliott Third Vice President
MSPA (1887), President MCP (1906—17): David M. R.
Culbreth MSPA First Vice President (1889) and Trea-
surer (1896—98), Professor MCP (1885 —1904); John F.
Hancock MSPA Third Vice President (1890), President
(1894) and Secretary (1895) President MCP (1873-75);
Charles Caspari, Jr. First Vice President MSPA (1890),
Professor and first Dean MCP (1879-1904); Henry P.
Hynson MSPA First Vice President (1894), and Presi-
dent (1895), First Professor of Dispensing Pharmacy
MCP (1900-04); Charles H. Ware Secretary MSPA
(1897—99), Last President MCP (1907 —08).33:34:35-36 37

REFERENCES

1. Minutes of the Maryland College of Pharmacy, 1873—1888, pp.
D425 D.

2. Edward Kremers and George Urdang, ‘“‘History of Pharmacy”’
2nd Ed., J. B. Lippincott Co., Philadelphia, 1951, p. 255.

3. Annual Announcement of the Maryland College of Pharmacy,
Session 1882-83.

4. B. F. Allen, Historical Collection of Notes, Etc.

5. Proceedings of the Maryland State Pharmaceutical Association,
1883, p. 5.

6. IBID, p. 6.

TL BID Ss peo:

8. IBID, p. 10.

9. Eugene F. Cordell, ‘‘University of Maryland,’ Volume-1, Lewis
Publishing Company, New York-Chicago, 1907, p. 453.

10. Reference 1, p. 311.

li? Reference 5; p: 11:

2 BIDS p14:

See BIDS p22 1,

14. Program, Golden Anniversary of the Maryland Pharmaceutical
Association (1882 —1932), Atlantic Hotel, Ocean City, Maryland,
June 21—24, 1932.

15. B. Olive Cole, ‘‘Historical Review of Pharmacy in Maryland,”
75th Diamond Jubilee, Maryland Pharmaceutical Association,
Galen Hall, Wernersville, Pennsylvania, June 24—27, 1957, p. 12.

APRIL, 1982

16. Proceedings of the Maryland State Pharmaceutical Association,
1884, p. 1.

17. IBID, 1885, p. 1.

18. Proceedings of the Maryland Pharmaceutical Association, 1886, p
1. (Note: State Not Used in Title).

19. Reference 15.

20. Proceedings of the Maryland Pharmaceutical Association, 1910,
Ppa ti-/83

21. IBID, 1912, pp. 169-172.

22. Reference 14.

23. Maryland Pharmacist, 1 (1925—26) 212.

24. IBID, p. 503.

25. IBID.

26. Maryland Pharmacist, 8 (1932 —33) 73-76.

27. Reference 1, p. 360.

28. Minutes of the Maryland College of Pharmacy 1888—1908, p. 31.

29. IBID, p. 39.

30. IBID, p. 81.

31. The May 28, 1881 issue of the Baltimore Sunpapers.

32. Proceedings of the Maryland State Pharmaceutical Association,
1895, p. 15.

33. Annual Announcement of the Maryland College of Pharmacy,
Sessions 1882—1886.

34. Annual Catalogue of the Maryland College of Pharmacy, Sessions
1886—1900.

35. Maryland Pharmacist, Proceedings number, October 1964, pp.,
197 —200.

36. Annual Announcement of the Maryland College of Pharmacy,
Sessions 1900—1904.

37. Minutes of the Maryland College of Pharmacy 1888—1908, pp.
2412578

Harry Finke Honored

Harry Finke, member and owner of the Medicine
Shoppe Pharmacy at 7116 Darlington Dr. in Baltimore
recently received the International Franchise Associa-
tion’s Distinguished Achievement Award from Jerry
Sheldon, President of Medicine Shoppe, International.

calendar

April 24-29—APhA Convention, Las Vegas
June 6-10—ASHP Annual Meeting, Baltimore
June 18-20—MSHP Annual Seminar, Williamsburg
June 20-24—MPhA Centennial Convention,

Ocean City
Nov 4-7—SAPhA Regional Convention, Baltimore

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8 THE MARYLAND PHARMACIST

The R&D maze is
a long and costly
road to travel.

Luck does not bring life-saving products to market....
a well planned Research and Development Program
does... but, the R&D maze is a long and costly road to
travel. Recent studies indicate that it takes as much as 10
years and $70 million to bring aq new medicine to market.
This year Pfizer will spend over $200,000,000 on R&D in
an effort to provide new products that are safe and effec-
tive and meet our high standards of quality. Pfizer's R&D
commitment today helps to assure better health tomorrow.

PHARMACEUTICALS
Pfizer Laboratories, Roerig, Pfipharmecs

APRIL, 1982

To keep drug product selection a workable
concept, pharmacists need information about
the source of drug products before they pur-
chase them.

The California Pharmacists Association
wrote to drug manufacturers and distributors,
asking them to provide new and updated in-
formation on which companies actually man-
ufacture the final dosage form. On these

pages is the latest information provided to the association.

We have added some drugs to the list because they are now available from a greater number of sources. All
information concerning the manufacturers of drug products applies only to those dosage forms and
strengths distributed by the companies. The distributor appears on the left, the manufacturer on the right.

Penicillin G 250 mg tabs and 125 and 250 mg liquid

H.R. Cenci Labs - - - - - - Biocraft Labs
Coast Labs - - - —----- Mylan Pharm.
Geneva Generics — — - - - - Mylan Pharm.
Lederle Labs - - - - - - - - Mylan Pharm.
McKesson Labs* —- —- - - — - Mylan Pharm.
Parmed Pharm.— -— -— - - - - Biocraft Labs
Penta Products— - - - - - - Biocraft Labs
Pfipharmecs - —- - —- --- —- Pfizer Pharm.
Purepac - - - ------- Purepac
Rugby Labs - - - - ~- -- - Mylan Pharm.
Smith Kline & French — — —- — Mylan Pharm.
E.R. Squibb & Sons- — —- - - E.R. Squibb & Sons
Towne, Paulsen & Co.— — —- — Mylan Pharm.
or Biocraft Labs
Vangard Labs* —- —- - - - - - Mylan Pharm.
West-Ward* - ------- Biocraft Labs
Wolins Pharmacal* — —- - —- - Zenith Labs

or Mylan Pharm. (tabs),
Biocraft Labs
Wyeth Labs — - —- - - - - - Wyeth Labs

Penicillin V Potassium

Beecham Labs - — - - - - - Beecham Labs
Coast Labs - ------- Mylan Pharm.
Geneva Generics -— -— - - - - Mylan Pharm.

or Biocraft Labs
ICN Pharm.* - - - ----- Zenith Labs
Ladco Labs - - ------ Rugby Labs'

or Mylan Pharm.
Lederle Labs - - - - - ~- —- - Lederle Labs
Eli Lily & Co.-------- Eli Lilly & Co.
McKesson Labs* — — - — — — Mylan Pharm.
Parke-Davis —- —- - —- —- - - - John D. Copanos & Co.
Parmed Pharm. — - — — - - - Biocraft Labs
Penta Products — —- — - - - - Biocraft Labs
Pfipharmecs — — — — - — - - Pfizer Pharm.
Purepac — — —- — — - -— - — — Purepac
Rexall Drug Co. —- —- - - - - Biocraft Labs

or Mylan Pharm.
A.H. Robins — - — -— - - - - Biocraft.Labs
Rowell Labs - - - - --- - Biocraft Labs
Rugby Labs - — - —- - —- - - Mylan Pharm.
Smith Kline & French -— — - — Mylan Pharm.
E.R. Squibb & Sons - - - - - E.R. Squibb & Sons
Towne, Paulsen & Co.— — — — Mylan Pharm.

or Biocraft Labs
The Upjohn Co.—- — — — — — — The Upjohn Co.
Vangard Labs’ —- ~ — — - - — Biocraft Labs
West-Ward* —- — - - - - - -— Biocraft Labs
Wolins Pharmacal* — - - —- - Biocraft Labs

or Zenith Labs (tabs),

Mylan Pharm. (25 mg tabs)

Wyeth Labs - - - ----- Wyeth Labs

Pentaerythritol Tetranitrate 10 and 20 mg tabs

HeRoeCenchilabsSa— 7 Zenith Labs

Coast. Cabs = = Bolar Pharm.
Geneva Generics -— -— - — —- — Bolar Pharm.
Invenex Pharm.* — -— - - - - Strong Cobb Arner

10

Ladco Labs - ------- Rugby Labs!

or Bolar Pharm.
McKesson Labs* —- — — —- —- - Zenith Labs
Parke-Davis - - - -— - - - - Parke-Davis
Parmed Pharm. — — - - — — - Zenith Labs or Bolar Pharm.
Penta Products — - - - —- —- — Bolar Pharm.
Purepac —- - - - ----- - Bolar Pharm.
Rugby Labs - - - - - - - - Bolar Pharm.
Stayner Corp. - - - - - - - Bolar Pharm.
Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.
Vangard Labs* - - - - —- - - Zenith Labs
West-Ward* - - - ----- West-Ward

Wolins Pharmacal* — —- —- — —

Phenobarbital 15, 30, 65 and 100 mg tabs
Barglabss—— —
EER EGenciitabse a
Drummer Labs —- —- —- - - - —
Geneva Generics - — - — - —
IGN Phatmn sa
Invenex Pharm.* - — — - —- —-
Lederle Labs - - - - - - - -
Eli Lily & Co.- - - - —- —-- —
McKesson Labs’ —- —- — —- — —
Parke-Davisa—_.—
Parmed Pharm. —- - -— - - - —-
Penta Products — -— - - — - —
Philips Roxane — - - — - — —

Bolar Pharm. or Zenith Labs

Barr Labs

Cord Labs or Richlyn Labs
Lemmon

Cord Labs

ICN Pharm.

Invenex Pharm.

Barr Labs

Eli Lilly & Co.

McKesson Labs
Parke-Davis

Zenith Labs or Richlyn Labs
Barr Labs

Philips Roxane

Purepac — - - - - —-- - - —- Purepac
Rugby Labs - - - - - -- - Marshall Pharm.
Smith Kline & French — -— — — Philips Roxane

Vangard Labs* - - - - - - -
West-Ward.
Wolins Pharmacal* —- —- - —- —-

Wyeth Labs - - - -----

Phenylbutazone 100 mg tabs
Geigy Pharm.- - - - - - - -
Geneva Generics — - - - - -
Parmed Pharm. — — - - - - -
Rugby Labs - —- - —- - - - —
USV Labs - - - ------

Phenytoin (Diphenylhydantoin)
Hina Genciitabsm— 1s
Coast. absme
Geneva Generics - - — - — —

Eaaco. Labsa———
Lederle Labs — — — — — — — —

THE MARYLAND PHARMACIST

Marshall Pharm.
West-Ward
Danbury Pharmacal
or Barr Labs
Wyeth Labs

Phenylbutazone and Antacid caps
H.R. Cenci Labs - - — - - -
Geigy Pharm.- - - - - - - -
Geneva Generics -— - - —- - -
tadco Labs
Parmed Pharm.— —- —- - - — -
Penta Products —- — - - - - -
Rugby Labs - - —- - - - - -
Stayner Pharm.— - - - - - -
WOW = seaseaea4

Premo Pharm.
Ciba-Geigy
Generic Pharm.
Premo Pharm.
Premo Pharm.
Zenith Labs
Chelsea Labs
Generic Pharm.
USV Labs
Premo Pharm.

Ciba-Geigy
Cord Labs
Premo Pharm.
Chelsea Labs
USV Labs

Generic Pharm.
Zenith Labs
Lannett Co.

or Generic Pharm.
Rugby Labs!
Generic Pharm.

:
:

Manufacturer
disclosure

McKesson Labs” — — —- — —- — Zenith Labs

Parke-Davis - —- —- —- - -—--- Parke-Davis
Parmed Pharm. — — —- -— - - - Zenith Labs
or Generic Pharm.
Penta Products - — - —- - - - Generic Pharm.
Rugby Labs —- - - —- - -- - Chelsea Labs
Vangard Labs* - - - - - - - Generic Pharm.
West-Ward* - ------- Zenith Labs
Wolins Pharmacal* —- — — - — Zenith Labs, Lannett Co.

or Generic Pharm.

Pilocarpine eyedrops

Allergan Pharm. — - - - - - Allergan Pharm.
Ayerst Labs - - - ---- - Ayerst Labs
Parmed Pharm.— - — — - - - Maurry Biological
Penta Products —- - - - - - - Ketchum Labs
Rugby Labs - - —- ----- Ketchum Labs
Wolins Pharmacal* -— — — — — Ketchum Labs

Potassium Chloride liquid 10% and 20%

H.R. Cenci Labs - —- - - —- - H.R. Cenci Labs

Coast Labs - - ------ Chemrich Labs

Geneva Generics - —-- — — — Bay Labs

Lederle Labs — —- — —- - — - - National Pharm.

Life Labs - -------- Life Labs

Parmed Pharm.— — - - — -— - National Pharm. or Bay Labs

Penta Products — -— - - - - - Life Labs

Pfipharmecs — — — —- — - - - Pfizer Pharm.

Philips Roxane — — — — — — - Philips Roxane

Purepac - - ~ —------- Purepac

Rugby Labs - - - - - -- - Clay Park Labs, Newtron
Pharm. or National Pharm.

Smith Kline & French — — — —- Philips Roxane

Stayner Corp. — - - - --- Whiteworth

Towne, Paulsen & Co.— — — -— Towne, Paulsen & Co.

Vangard Labs* - - - - - - - National Pharm.

Wolins Pharmacal* — —- — —- — National Pharm.

or Newtron Pharm.

Prednisotone 5 mg tabs

H.R. Cenci Labs - - - - - - Zenith Labs or Richlyn Labs

Geneva Generics -— -— - - - - Cord Labs

ICN Pharm.* — - - - ---- ICN Pharm.

Ladco Labs - - ------ Rugby Labs! or
Chelsea Labs

McKesson Labs* - - - - - - McKesson Labs

Parmed Pharm. — - - - - - - Zenith Labs, Danbury
Pharmacal or Richlyn Labs

Penta Products — - - - - — - Zenith Labs

Pfipharmecs — - - —- - - - - Pfizer Pharm.

Philips Roxane - — — - - - - Philips Roxane

Purepac —- - - - ------ Purepac

Rugby Labs - —- - ----- Chelsea Labs

Towne, Paulsen & Co.- — - - Towne, Paulsen & Co.

The Upjohn Co.- - - - - - - The Upjohn Co.

Vangard Labs* — — - - - - - Generic Pharm.

West-Ward* - - - ---- - West-Ward

Prednisone 5 mg tabs

Barr Labs - —- - - —----- Barr Labs

H.R. Cenci Labs - - — - -— - Halsey Drug Co.

Central Pharm. — - - - -— - - Central Pharm.

Geneva Generics — — — — — -— Cord Labs or Barr Labs

ICN Pharm.” — —- —- - - - - - ICN Pharm.

Ladco Labs ~- - ------ Rugby Labs! or
Chelsea Labs

Lederle Labs —- - - —- —- - - - Danbury Pharmacal

McKesson Labs” —- - — - —- - McKesson Labs

Parmed Pharm. — - - — - — - Richlyn Labs, Heather Drug
Co. or Zenith Labs

Penta Products — — - - - - - Barr Labs

Philips Roxane —- —- - - - - - Philips Roxane

* No response was received from this company. The information
listed has been taken from previous articles,

1 See the Rugby listing to determine the manufacturer of this
product.

APRIL, 1982

Purepac == = Se eS Purepac

Rexall Drug.Co. == === = Barr Labs

Rowell Labs — — - — —- — — — Rowell Labs

Rugby Labs —— — = — == Chelsea Labs
Schering: GOrp ee Schering Corp.

Smith Kline & French — - — — Philips Roxane
Stayner, GOrp = Philips Roxane
Towne, Paulsen & Co.— — ~ — Towne, Paulsen & Co.
The. Upjohn Co ==>] >= — The Upjohn Co.
Vangard Labs* —- - - — - - - Generic Pharm.
West-Ward* - — —- —-- —- - — West-Ward

Wolins Pharmacal* - - - —- - Ketchum Labs, Generic

Pharm., Zenith
Labs or Richlyn Labs

Probenecid with Colchicine tabs

H.R. Cenci Labs — - — — — — Richlyn Labs

Geneva Generics — - -— - - - Zenith Labs

Ladco Labs - ------- Rugby Labs! or Chelsea
Labs

Lederle Labs - - - — — — — Danbury Pharmacal

McKesson Labs* — - - — - — Richlyn Labs

Merck Sharp & Dohme — — — Merck Sharp & Dohme

Parmed Pharm. — - — — — — - Zenith Labs or Danbury
Pharmacal

Penta Products — — - -— — - - Danbury Pharmacal

Purepac —- —- —- ---—----- Richlyn Labs

Rugby Labs — —- —- —- - —- - - Chelsea Labs

Stayner Corp. -— -— - - - - - Danbury Pharmacal

Towne, Paulsen & Co. — — — — Danbury Pharmacal

West-Ward* -— - - ----- Danbury Pharmacal

Wolins Pharmacal* — - —- —- - Richlyn Labs or Zenith Labs

Probenecid 500 mg tabs

Geneva Generics — — -— - - - Mylan Pharm.

Ladco Labs - - - - -- - - Rugby Labs!

Lederle Labs - —- — - - - - - Mylan Pharm.

McKesson Labs* — —- —- - —- — Mylan Pharm.

Merck Sharp & Dohme — — — Merck Sharp & Dohme

Penta Products - —- —- - - - - Danbury Pharmacal

Purepac —- —- - - ------ Mylan Pharm.

Rugby Labs - —- - - ~ - - - Mylan Pharm. or
Chelsea Labs

Smith Kline & French -— - - — Mylan Pharm.

Stayner Corp. - ------ Mylan Pharm.

Wolins Pharmacal* - - - — - Richlyn Labs or Zenith Labs

Procainamide 250, 375 and 500 mg caps

H.R. Cenci Labs —- - — —- — - Bolar Pharm.

Coast Labs - - ------ Bolar Pharm.

Geneva Generics - - - - - — Zenith Labs or Bolar Pharm.
Ladco Labs - ------- Rugby Labs!

Lederle Labs —- — - —- - -—- - - Danbury Pharmacal
Parke-Davis -— - — - —- - - - Parke-Davis

Parmed Pharm.- —- - - - - - Zenith Labs or Bolar Pharm.
Penta Products — - - - - - - Zenith Labs

Purepac - - -------- Bolar Pharm.

Rugby Labs ~ - - - - - ~ - Chelsea Labs

Stayner Corp. - -— - - - - - Danbury Pharmacal

E.R. Squibb & Sons-— - —- — - E.R. Squibb & Sons

Towne, Paulsen & Co.— - — — Bolar Pharm. (250 & 500 mg)

Danbury Pharmacal (375 mg)

Promethazine Expectorant with Codeine

H.R. Cenci Labs —- — — — — - H.R. Cenci Labs

Geneva Generics — - — - — - Cord Labs or Bay Labs

Lederle Labs - — - - - - - - National Pharm.

LifelLabs -~-------~- Life Labs

Parmed Pharm.— — — — ~ - - Bay Labs or National Pharm.

Penta Products— — — — - — — Life Labs

Purepac — -— — -— —- —- - —- - —- Purepac or National Pharm.

Rugby Labs — — — - - - - - Halsey Drug Co. or National
Pharm.

Stayner Corp, — — — — — — — Cord Labs or Bay Labs

Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.

Vangard Labs* - - - — - —- - National Pharm.

ll

Wolins Pharmacal*
Wyeth Labs

Bay Labs or National Pharm.
Wyeth Labs

Promethazine Expectorant Pediatric

H.R. Cenci Labs
Geneva Generics — — - - - -
Life Labs
Parmed Pharm.— — - —- - - -
Penta Products — — - - - - -
Rugby Labs = zs

Stayner Corp.
Vangard Labs* — - —- - - — -
Wolins Pharmacal*
Wyeth Labs

H.R. Cenci Labs

Bay Labs

Life Labs

National Pharm. or Bay Labs
Life Labs

Bay Labs or National Pharm.
Bay Labs

National Pharm.

National Pharm.

Wyeth Labs

Promethazine Expectorant with Phenylephrine

H.R. Cenci Labs
Geneva Generics — — - -— — -
Life Labs — —- - --—-

Parmed Pharm.— — —- - - - -
Penta Products —- — - - - - -
Rugby Labs
Stayner Corp.
Vangard Labs* - - - - - - -
Wolins Pharmacal*
Wyeth Labs

Promethazine Expectorant Plain

H.R. Cenci Labs
Geneva Generics —- — —- - - -
Lederle Labs —- —- ~ —- - - - -
Life Labs
Parmed Pharm.— —- - —- - - -
Penta Products — — -— - - - -
Purepac - - - -------
Rugby Labs
Stayner Corp.
Towne, Paulsen & Co. — —- — -
Vangard Labs* - —- — - - - -
Wolins Pharmacal*
Wyeth Labs

H.R. Cenci Labs

Cord Labs or Bay Labs

Life Labs

National Pharm. or Bay Labs
Life Labs

Bay Labs or National Pharm.
Bay Labs

National Pharm.

National Pharm.

Wyeth Labs

H.R. Cenci Labs

Cord Labs or Bay Labs

National Pharm.

Life Labs

National Pharm. or Bay Labs
Life Labs

Purepac or National Pharm.
Bay Labs or National Pharm.
Bay Labs

Towne, Paulsen & Co.
National Pharm.

National Pharm. or Bay Labs
Wyeth Labs

Propantheline Bromide 15 mg tabs

H.R. Cenci Labs
Coast Labs
Geneva Generics - — —- - - -
Ladco Labs
Lederle Labs — --

McKesson Labs* — - — - —- -
Parmed Pharm. — — - —- — - -

Penta Products- —- - - - - -
Philips Roxane - —- - - - - -
Purepac —— - -—
Rugby Labs

Searle Pharm.
Smith Kline & French —- - - -
Stayner Corp. - - - - - - -
Vangard| Eabs'
West-Ward’*
Wolins Pharmacal*

Propoxyphene HCI 65 mg caps

H.R. Cenci Labs
Coast Labs Se
Geneva Generics — - — —- — -
ICN Pharm.* =
Ladco Labs

Lederle babs.
Eli Lily & Co.-_-------
Parke-Davis
Parmecunianns——— sn

Penta iProgucts =.

Cord Labs

Cord Labs

Cord Labs

Rugby Labs!

Mylan Pharm.

Danbury Pharmacal

Bolar Pharm., Heather Drug
Co. or Danbury Pharmacal
Danbury Pharmacal

Philips Roxane

Purepac

Heather Drug Co. or Mylan
Pharm.

Searle & Co.

Philips Roxane

Cord Labs

Heather Drug Co.

Danbury Pharmacal

Mylan Pharm. or Danbury
Pharmacal

Richlyn Labs

Cord Labs

Cord Labs or Zenith Labs
ICN Pharm.

Rugby Labs! or Chelsea
Labs

Lederle Labs

Eli Lilly & Co.
Parke-Davis

Zenith Labs, Richlyn Labs or
Premo Pharm.

Barr Labs

PhillpS ROxanel= =a ee
PUIG P aC eee cen
Rugby Labs
Smith Kline & French — — — —
E.R: Squibb GiSons= = =
Stayner Corp.
Towne, Paulsen & Co.— — — —
Vangandy abs geen
West-Ward*
Wolins Pharmacal*

H.R. Cenci Labs
Coast Labs
Geneva Generics — — - — —- —
IGNUPharmne
Ladco Labs

Eederle: Fabs ===

STM CCC = oe eas =
Parke: Davis #=.— ees
Ratmed: Phanni tn

RentanetOCUCtS =meesmreme rE
IPAnoyss (RYOREV AVS) = a a
Purepac -

Rugby Labs
Smith Kline & French — — — —
Stayner Corp.
ems Sew es SOM=— =] S =
Towne, Paulsen & Co.— — — —

Vangadiab Sane
West-Ward*
Wolins Pharmacal*

Quinidine Sulfate 200 mg tabs

H.R. Cenci Labs
Geneva Generics — — — — — —
MEVAMAEWG = = oes =
Ladco Labs

EederlesitabS tes m—=—e meen
SHUI C2 Cloen a eo SSS
MeKesson Eats —
Parke-Davis
Parmediehatm:

RentanpiOGUC(S samme
PnilipStROX ane hse
PULCD AC ee
Rowell, Cabss— = = — = — = =
Rugby Labs
Smith Kline & French — — — —-
Stayner Corp.
Towne, Paulsen, Co. — — —- -
Vangard Labs* - —- - —- - - -
West-Ward*
Wolins Pharmacal*

Reserpine 0.25 mg tabs

Coast Labs
Drummer Labs — — — — — — —
Geneva Generics — - —- — - —
IGNEPh alae
Ladco Labs

Philips Roxane

Purepac

Chelsea Labs

Smith Kline & French
Mylan Pharm.

Cord Labs

Anabolic or Generic Pharm.
Zenith Labs

West-Ward

Zenith Labs, Premo Pharm.
or Richlyn Labs

Propoxyphene HCI 65 mg compound caps

Zenith Labs

Cord Labs

Cord Labs or Zenith Labs
ICN Pharm.

Rugby Labs! or
Chelsea Labs

Lederle Labs or

Mylan Pharm.

Eli Lilly & Co.
Parke-Davis

Zenith Labs, Cord Labs
or Premo Pharm.
Zenith Labs

Mylan Pharm.

Mylan Pharm.

Chelsea Labs

Smith Kline & French
Cord Labs

Mylan Pharm.

Caribe Chem. Co. or
Mylan Pharm.

Zenith Labs

Caribe Chem. Co.
Mylan Pharm., Premo
Pharm., Zenith Labs or
Richlyn Labs

Zenith Labs

Cord Labs

Key Pharm.

Rugby Labs! or
Chelsea Labs

Barr Labs or Lederle Labs
Eli Lilly & Co.
Danbury Pharmacal
Parke-Davis

Richlyn Labs, Zenith
Labs or Danbury
Pharmacal

Danbury Pharmacal
Philips Roxane
Purepac

Rowell Labs
Chelsea Labs
Philips Roxane
Danbury Pharmacal
Carnegie Labs
Carnegie Labs
West-Ward

Zenith Labs, Blue Cross
Products, Danbury
Pharmacal or
Chromalloy Pharm.

Richlyn Labs

Ciba-Geigy

Cord Labs

Lemmon

Cord Labs or Zenith Labs-
ICN Pharm.

Rugby Labs! or

Chelsea Labs

THE MARYLAND PHARMACIST

Lederle Labs
Eli Lilly & Co.
McKesson Labs’

Danbury Pharmacal
Eli Lilly & Co.
McKesson Labs

Parmed Pharm.— — ~— - — - — Zenith Labs or Barr Labs

Penta Products
Philips Roxane
Purepac

Rugby Labs

Barr Labs
Philips Roxane
Purepac
Chelsea Labs

Smith Kline & French — — -— — Philips Roxane

E.R. Squibb & Sons

E.R. Squibb & Sons

Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.

The Upjohn Co.
Vangard Labs*
West-Ward’*
Wolins Pharmacal*

Spironolactone 25 mg tabs
Barr Labs
H.R. Cenci Labs
Coast Labs
Geneva Generics — — —
Ladco Labs
Lederle Labs
Parmed Pharm.— -

Penta Products— —
Purepac

Rugby Labs

Searle Pharm. — - -
Stayner Corp. — — -
Towne, Paulsen & Co.

The Upjohn Co.

Generic Pharm.
West-Ward

Generic Pharm, Tablicaps,
Chromalloy Pharm. or
Zenith Labs

Barr Labs
Bolar Pharm.
Bolar Pharm.
Cord Labs
Rugby Labs!
Mylan Pharm.

- Zenith Labs, Bolar Pharm.

or Cord Labs
Zenith Labs

Bolar Pharm.
Chelsea Labs
Searle & Co.
Bolar Pharm.
Bolar Pharm.

Spironolactone with Hydrochlorothiazide

Barrlttabsaar— = =] Se
H.R. Cenci Labs

Coast Labs

Geneva Generics

Ladco Labs

Lederle Labs

Parmed Pharm. —

Penta Products
Purepac

Rugby Labs

Searle Pharm.
Stayner Corp.

Towne, Paulsen & Co.
Whiteworth

Sulfisoxazole 500 mg tabs
Batteltal Saas
FiReGenciabSm
Coast Labs

Geneva Generics
Hoffmann-La Roche
ICN Pharm.*

Ladco Labs

Lederle Labs
McKesson Labs*
Parmed Pharm.

Penta Products
Philips Roxane
Purepac

Rugby Labs

Barr Labs

Bolar Pharm. or Zenith Labs
Bolar Pharm.

Cord Labs

Rugby Labs

Mylan Pharm.

Zenith Labs, Bolar Pharm.
or Cord Labs

Zenith Labs

Bolar Pharm. or

Mylan Pharm.

Chelsea Labs

~ Searle & Co.

Bolar Pharm.

- Bolar Pharm.

Bolar Pharm.

_ Barr Labs

Cord Labs

Cord Labs or Zenith
Labs

Cord Labs
Hoffmann-La Roche
ICN Pharm.

Rugby Labs’ or
Chelsea Labs

Cord Labs
McKesson Labs
Zenith Labs, Bolar Pharm.
or Cord Labs

Barr Labs

Philips Roxane
Cord Labs

Chelsea Labs

Smith Kline & French — — - — Smith Kline & French

EE

* No response was received from this company. The information
listed has been taken from previous articles.
1 See the Rugby listing to determine the manufacturer of this

product.

APRIL, 1982

Stayner Corp. Barr Labs

Towne, Paulsen & Co.— — —- — Dow Chem or Mylan Pharm.

The Upjohn Co. The Upjohn Co.

Vangard Labs* Cord Labs

West-Ward* West-Ward

Wolins Pharmacal* Heather Drug Co., Zenith
Labs or Barr Labs

Sulfisoxazole and Phenazopyridine

H.R. Cenci Labs
Coast Labs

Geneva Generics
Hoffmann-La Roche
Parmed Pharm.
Penta Products
Philips Roxane
Rugby Labs
Vangard Labs*
Wolins Pharmacal*

Richlyn Labs

Cord Labs or Richlyn Labs
Standard Pharmacal
Hoffmann-La Roche
Heather Drug Co.

Richlyn Labs

Richlyn Labs

Standard Pharmacal
Standard Pharmacal
Richlyn Labs

Tetracycline HCI 250 and 500 mg caps and liquid

H.R. Cenci Labs
Central Pharm.
Geneva Generics

Richlyn Labs

Mylan Pharm.

Barr Labs, Zenith Labs

or ICN Pharm.

ICN Pharm.

Mylan Pharm.

Rugby Labs or Chelsea Labs

McKesson Labs

Parke-Davis

Richlyn Labs, Heather Drug

Co. or Pierrel America

Penta Products Richlyn Labs or Zenith Labs

Pfipharmecs Pfizer Pharm.

Purepac Purepac

Rachelle Labs Rachelle Labs

Rexall Drug Co. Mylan Pharm.

A.H. Robins A.H. Robins

Rugby Labs Chelsea Labs

Smith Kline & French — — — — Mylan Pharm. (caps) or
McKesson Labs (syrup)

E.R. Squibb & Sons E.R. Squibb & Sons

Towne, Paulsen & Co.- — — — Towne, Paulsen & Co.

The Upjohn Co. The Upjohn Co.

Vangard Labs* Heather Drug Co. (caps) or

National Pharm (liquid)

West-Ward

Zenith Labs, Mylan Pharm.,

Heather Drug Co.,

Chromalloy Pharm. or

Richlyn Labs

Wyeth Labs

ICN Pharm.”
Invenex Pharm.*
Ladco Labs
McKesson Labs*
Parke-Davis
Parmed Pharm.

West-Ward’
Wolins Pharmacal*

Wyeth Labs

Theophylline tabs and caps, sustained or regular action

Central Pharm.
Vitarine Labs

Central Pharm.
Geneva Generics
Norwich-Eaton Baylor Labs
Riker Labs Riker Labs
Schering Corp. - — — - - — — K.V. Pharm.
Stayner Corp. Central Pharm.

Theophylline, Ephedrine and Phenobarbital

Bolar Pharm.

Cord Laps

Cord Labs or Zenith Labs
Invenex Pharm. or Cord Labs
Parke-Davis

Cord Labs

Bolar Pharm.

H.R. Cenci Labs
Coast Labs
Geneva Generics
Invenex Pharm.*
Parke-Davis
Parmed Pharm.
Penta Products
Rugby Labs Chelsea Labs

Stayner Corp. Cord Labs

Towne, Paulsen & Co.— — — — Towne, Paulsen & Co.
Vangard Labs* Danbury Pharmacal (tabs)
or National Pharm. (liquid)
West-Ward

Drummer Labs or
Chromalloy Pharm.

West-Ward’
Wolins Pharmacal’

is

Thyroid 30, 65, and 120 mg tabs

Western Research Labs
ICN Pharm.

Invenex Pharm.
Western Research Labs
Eli Lilly & Co.
Parke-Davis

McKesson Labs
Richlyn Labs, Heather
Drug Co. or Bowman

Geneva Generics — — — - - -
ICN Pharmte = =
Invenex Pharm.* — — - —- - -
Lederle Labs SS oe

Eli Lily & Co—-------
Marion Labs — — — — — — - -
McKesson Labs* —- — - - —- -
Parmed Pharm.— — - —- - - —

Penta Products— — - - - - - Barr Labs
Purepac -- —— Purepac
Rugby Labs - —- - - ~ - - - Marshall Pharm. or

Chelsea Labs
Vangard Labs” — — - — - - - Western Research Labs
West-Ward* - —- ------ West-Ward
Wolins Pharmacal* — — —- — — Generic Pharm. or
Chromalloy Pharm.

Tolbutamide 500 mg tabs

Barr Labs - - ------- Barr Labs

H.R. Cenci Labs - — —- - - - Premo Pharm.

Geneva Generics — -— - -— -— - Cord Labs or Mylan Labs
Ladco Labs - - - ---- - Rugby Labs!

Lederle Labs — - - — - - - ~ Lederle Labs or Mylan
Pharm.

Parmed Pharm.— —- — — - - - Premo Pharm. or Zenith Labs

Penta Products— — - — — - - Zenith Labs
Purepac — - - - ------ Cord Labs
Rexall Drug Co. - - - - - - Mylan Pharm.
Rugby Labs — — — —- — — —- — Chelsea Labs
Smith Kline & French — — — — Smith Kline & French
Stayner Corp. - - ----- Mylan Pharm.
E.R. Squibb & Sons— —- - —- - Mylan Pharm.
Towne, Paulsen & Co.— — — — Mylan Pharm.
The Upjohn Co.- — - - - - - The Upjohn Co.
Triamcinolone cream or ointment
Geneva Generics — — — - - - Thames Pharm.

Ladco Labs Rugby Labs!
Lederle Labs —- —- —- —- - - - - Lederle Labs
Parmed Pharm.— — -— -— - - - Premo Pharm.
Rugby Labs —- —- - - - - - - Clay Park Labs
Smith Kline & French - — — — Philips Roxane

E.R. Squibb & Sons— - - - —- E.R. Squibb & Sons
Wolins Pharmacal* —- — —- - - Premo Pharm.

Trihexyphenidy! HCI 2, 5 mg tabs

H.R. Cenci Labs - - - - - - Bolar Pharm.
Coast Labs - - - - —---- Bolar Pharm.
Geneva Generics - - - —- - - Bolar Pharm.
Ladco Labs - - - — - - Rugby Labs!
Parmed Pharm.— — — — —- - - Bolar Pharm.

Penta Products— — - — - - - Danbury Pharmacal
Rugby Labs — —- —- - - - - - Bolar Pharm. or

Danbury Pharmacal

Trihexyphenidy! HCI 2 and 5 mg tabs

Schering Corp. — — — — — — = Schering Corp.
Stayner Corps. Danbury Pharmacal
Towne, Paulsen & Co.— — - - Bolar Pharm.
WinitewOnth ete Bolar Pharm.

Triprolidine and Pseudoephedrine tabs, elixir or expectorant

14

Burroughs Wellcome Co.
H.R. Cenci Labs

— — Burroughs Wellcome Co.
aS SSeS Generic Pharm. or Zenith
Labs (tabs) or H.R.
Cenci Labs (liquid)

Coast Labs - M.D. Pharm.
Geneva Generics - — - — - - Bay Labs
Ladco Labs - - Premo Pharm. (tabs)
or Barr Labs (syrup)
Rammed Phar. Bay Labs, National Pharm.,
Premo Pharm. or Cord Labs
Penta Products— — — — — — — Life Labs
Philips Roxane — —— — — — — Philips Roxane
Purepac — — — —_— -- Bolar Pharm. (tabs) or

National Pharm. (syrup)

Rugby! labs a= era Bay Labs or National Pharm.

StayneG Con = Generic Pharm. (tabs) or
Bay Labs (syrup)

Towne, Paulsen & Co.— ~— — — National Pharm.

Triprolidine and Pseudoephedrine with Codeine Expectorant
Burroughs Wellcome Co. - — Burroughs Wellcome Co.
H:R. Cenci Labs - = —- — = - H.R. Cenci Labs

Geneva Generics - — - - — - Cord Labs or Bay Labs
Life Pabs i= Life Labs

Penta Products == =a Life Labs

Rugby Labs eee National Pharm. or

Halsey Drug Co.
Stayner Corp. - Bay Labs
Vangard Labs" — —~ = — — — — National Pharm.
Wolins Pharmacal* - — - - —- National Pharm.

APhA Appoints Task Force
on Pharmacy Education

The Board of Trustees of the American Phar-
maceutical Association (APhA) has appointed a Task
Force on Pharmacy Education which will conduct a
comprehensive review and analysis of all aspects of
pharmaceutical education.

Among the issues the group will address are the
content and length of the pharmacy curriculum leading
to the entry degree, the title of that degree, the type of
training required for licensure, education and training at
the post-entry degree level, and the awarding of exter-
nal degrees.

Eminent educators John C. Weaver of Los Angeles,
California, and Lloyd M. Parks of Columbus, Ohio, will
head the task force as chairman and vice chairman, re-
spectively.

Cancer Society Elects
Freedenberg

At it’s recently held Annual Meeting, the American
Cancer Society, Maryland Division, Inc. installed Mar-
vin Freedenberg, P.D. as Chairman of the Board of Di-
rectors.

The 163 volunteer members comprising the House
of Delegates, elected Mr. Freedenberg for a term of two
years. Mr. Freedenberg has been a volunteer for the
American Cancer Society for 13 years, being active at
the community and state level. He has held numerous
positions of leadership including Montgomery County
Patient Service Chairman, Montgomery County Presi-
dent, State Budget and Finance Chairman, State Public
Issues Chairman and State Vice Chairman of the Board.

Mr. Freedenberg is co-owner of Drug Lane Phar-
macy and is affiliated with the Prince George’s-
Montgomery Pharmaceutical Association. He is a Fel-
low of the American Society of Consultant Pharmacists.
He and his wife, Margie, live in Silver Spring.

THE MARYLAND PHARMACIST

Now you can get

Blue Cross and Blue Shield

coverage regardless
of your health

se
BD

)

| \\\

Now, during a special
Open Enrollment period, you can
obtain Blue Cross and Blue Shield group
coverage through the Maryland Pharmaceutical

Association. It’s ANOTHER BENEFIT OF MPhA
MEMBERSHIP.

Even if you’ve been unable to obtain coverage in the
past, now you can. And no personal health statements or
medical questionnaires are required for membership. You
will be accepted automatically.

Even health conditions that currently exist will be

covered from the first day of enrollment in this special
Blue Cross and Blue Shield program. No waiting periods

2

are required. It’s all guaranteed by the Maryland Pharma-

ceutical Association and Blue Cross and Blue Shield of
Maryland.

But you must act quickly. Open Enrollment ends on
May 31, 1982.

Take a look at this comprehensive package

of benefits:

The Special Blue Cross hospital cost protection program
you'll receive provides full coverage for up to 365 days of
hospital inpatient care. This coverage includes semi-
private room, board, general nursing care, and other
customary hospital services, plus up to 365 days of inpa-
tient maternity care.

The Blue Shield Plan C program available to MPhA
members provides the most comprehensive package of
medical-surgical and obstetrical benefits available from
Blue Shield of Maryland. Payments to physicians are
based on the “reasonable cost”’ of covered services,

\

Re

and are not tied toa
fixed-fee schedule or schedule
of benefits.

Special Added Features:
Also included in this comprehensive package of
protection is Blue Cross and Blue Shield’s Special Diag-
nostic Endorsement # 4, a special Outpatient Benefit
Package, and a Student Endorsement that allows
dependent students to remain on a parent’s membership
until age 25. But that’s not all!

The special program of health care protection
designed by your association also includes a $250,000
Major Medical program which provides additional benefits
for covered services which extend beyond the scope of
your basic coverage.

Sign up during Open Enrollment

Just clip and mail the coupon below. One of our repre-
sentatives will contact you with complete information
including rates on the only health care protection
program available through your association. But you
must act quickly. Your automatic acceptance in this
outstanding program of health care protection is assured
during the special Open Enrollment from May 1, 1982 to
May 31, 1982.

Mail to:
Blue Cross and Blue Shield
700 East Joppa Road
Baltimore, Maryland 21204
Attn: Jack Ware, Association Sales
Department 114
I would like additional information on the special MPhA
Program.

Naine = ae eee
Stree Address a eee eS
—————EE——E— -state—— . = VA yo

Company Name ——__— =

Number of Employees ———_______

ee es ee ee ee

If our new Order Entry System
doesn’t save you time and money —
within 60 days, you clon’t
Owe us a dime for the system.

¢ Order 50% ¢ Place Orders

Faster In 60-Seconds
¢ Better — ¢ [tem and
Stock Shelf Labels
Condition
¢ Complete
¢ Better Pricing and
Pricing Product
Information Information

District Wholesale Drug Corp.
7721 Polk Street
Landover, MD 20785
(301) 322-1100

Loewy Drug Co.
6801 Quad Avenue
Baltimore, MD 21237
(301) 485-8100

Spectro Industries, Inc.
Jenkintown Plaza
Jenkintown, PA. 19046
(215) 885-3676

Divisions of

APRIL, 1982

"AS UPJOHN
PHARMACISTS, THEIR
GREAT SATISFACTION
IS IN HELPING YOU
AND THE PHYSICIAN
MAKE THE RIGHT

DRUG DECISIONS FOR
OPTIMAL PATIENT

$

\

© 1982, The Upjohn Company, Kalamazoo, Michigan

RR

The Industry Relations
Committee Says:

Make April
The Month
You Clean Out
Dated

Merchandise

The Industry Relations Committee of the Maryland
Pharmaceutical Association formed a subcommittee to
study the issue of a Model Return Goods Policy. It was
the feeling of the Committee, which is made up of man-
ufacturing representatives and practicing pharmacists,
that the policy should be fairly comprehensive and yet,
provide some guidance and consistency in this area.
The goal of the Committee was to develop a policy
which could be endorsed by the Association in an at-
tempt to establish a standard and which would be ac-
ceptable to both manufacturers and retailers.

The Committee recommends that members retain
this page from the journal and refer to the following
MPhA adopted policy whenever a question concerning
returning merchandise arises. In addition, the Industry
Relations Committee serves as an ombudsman
whenever members refer a problem concerning this
subject in writing to it.

MODEL RETURN GOODS POLICY

1. New prescription drug products shipped to the
pharmacy automatically by the manufacturer or
wholesaler may be returned at any time for
credit or exchange.

2. Regardless of expiration dates products may be
returned for credit or exchange at any time, pro-
viding they are sealed, intact, original packages.

3. For patient protection, open packages of pre-
scription drug products which are outdated may
be returned for at least partial credit.

4. Authority for returns may be required by the
pharmaceutical manufacturer or wholesaler—a
form should be provided to the pharmacy.

18

SAMPLE FORM to Return Merchandise

TO:(Name of Manufacturer)
Address—including the name of Town, County, State and Zip
Code

(Note—the above as well as the policy for making returns may be located in the
NWDA list of Mfgs. in January 1977 edition of the American Druggist
Blue Book).

Please grant us authorization to return the following
pharmaceuticals of your manufacture as per your
policy:

It is best to list the items—listing complete packages as well
as open containers. If a return of a schedule 2 is requested,
be sure to give exact count and hold these aside as they
usually will send a narcotic form. (Because of mail rates, it
may be less expensive to have the drug inspectors destroy
them.)

Note—If in their reply, they say they do not accept
open containers—or—partially filled ones,
call their attention to the fact that for the pro-
tection of the patient, as well as the pharma-
cist and the manufacturer, you believe it best
they change their policy to permit them to ac-
cept them for credit.

THE MARYLAND PHARMACIST

Mary Ann Frank (left), bookkeeper for the MPhA for the past Toastmaster Elwin Alpern, (left) presents President Frank Marinelli
twenty years, receives the Honorary President’s Plaque from with the NARD Leadership Award.

BMPA President Frank Marinelli (right) for her service to the
profession of pharmacy.

The BMPA Banquet was held February 14, 1982 at the Blue Crest Chairman of the MPhA Centennial Celebration Committee, William
North in Baltimore with over 250 pharmacists, family and friends Skinner makes a few announcements at the Banquet. The BMPA
in attendance. banquet helped to kick-off the year-long Centennial Celebration.

This page donated by
District-Paramount
Photo Service.

DISTRICT PROTO Int

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
in Baltimore, 792-7740

Pictures courtesy Abe Bloom — District Photo

APRIL, 1982 19

A Brief History of USPHS
Pharmacy in Maryland

George F. Archambault

INTRODUCTION

William Skinner, pharmacist and attorney, long ac-
tive in the affairs of the Maryland Pharmaceutical As-
sociation, has requested that I compile a brief history of
U.S.P.H.S. Pharmacy in Maryland for inclusion in The
Maryland Pharmacist relative to the celebration of the
Association’s first hundred years of existence. This is
that history. It has been compiled with the help of many
PHS pharmacists, some retired and others on active
duty. Where possible ‘‘credit lines’? are given. It is
hoped that this short history will help serve to record for
posterity the USPHS’s activities of pharmacists and
pharmacy in Maryland.

For the sake of easy identification, the activities are
segregated as follows:

Chapter 1. U.S.P.H.S. Hospital, Baltimore, MD (for-
merly U.S. Marine Hospital)

Chapter 2. The USPHS Perry Point Depot

Chapter 3. The Pharmacy at the Clinical Center, National
Institute of Health (NIH)

Chapter 4. Pharmacists serving in other non-Pharmacy
government activities in Maryland.

Chapter 5 thru 14 Miscellaneous (Activities and Ranks)

PART 1
The USPHS Hospital, Baltimore, MD

We are indebted to Karl H. Holtgreve, a well known
pharmacist in Maryland Pharmacy circles for the fol-
lowing list of Chain of Commands and years of service
at the hospital’s Pharmacy Department.

CHIEF PHARMACIST
U.S. PUBLIC HEALTH SERVICE HOSPITAL
Baltimore, Maryland, 21211

Prior to 1942 Records not available

Hanna, William M.
Scigliano, John A.
Dodds, Arthur W.

Proper, Robarts
Wolfthal, Abraham
Crisalli, Joseph P.
Gladhart, Wesley R.
Lesage, Paul J.
Johnson, Kent T.
Tonelli, Robert

20

1942 —1950
1950 =1952
19521956
19561957,
1957 1961
1961 —1962
1962 —1965
1965 —1970
1970-1978
1978 —1982

DEPUTY CHIEF PHARMACIST
U.S. PUBLIC HEALTH SERVICE HOSPITAL
Baltimore, Maryland, 21211
Prior to 1950 2

Ames, Reed
Brands, Allen

1950-1951
19512 1952
1952-1955
1953=1955
19561937
1957=1973
1973 =1974
19741979
LOI 1982

Verhulst, Louis
Bolte, Richard
Baughman, Bertram
Holtgreve, Karl H.
Walker, Thomas
Buehler, Gary
West, Robert

CHIEF PHARMACISTS
U.S. PUBLIC HEALTH SERVICE
OUT-PATIENT CLINIC
U.S. Custom House
Baltimore, MD 21201

Hens, Louis L.
Holtgreve, Karl H.

1933937
193 7950

After 6-1-50, Pharmacy service was supplied directly by
the Baltimore PHS Hospital and this clinic was closed.

PHARMACY RESIDENCY APPOINTMENTS!

Maryland Pharmacists receiving Pharmacy Residency
Appointments and Commissions as USPHS Officers:

West, Robert L. Univ. of Maryland 1970
Jarosinski, Paul F. Univ. of Maryland 1976
Shawger, Christopher L. Univ. of Maryland 1976
Clark, Larry C. Univ. of Maryland 1977
Brophy, Margaret C. Univ. of Maryland 1977
Melito, Mary P. Univ. of Maryland 1980
Meyer, Mary A. Univ. of Maryland 1980

‘Information supplied by Pharmacist Director Richard J. Ber-
tin, Ph.D., Deputy Chief, Professional Services Branch, Division
of Hospitals and Clinics, BMS, USPHS.

HISTORY OF PHARMACISTS IN
THE U.S.P.H.S.7

‘*Until the turn of the present century, physicians
and pharmacists were the only professionally trained

2 This over all history of pharmacists U.S.P.H.S. is taken from
R.C. William’s text ‘‘The United States Public Health Service
1798—1950,”’ p. 529-532.

THE MARYLAND PHARMACIST

persons employed in the Service hospitals and health
activities. Pharmacists have been employed in the Ser-
vice since its very beginning, under a variety of desig-
nations, i.e., apothecary, hospital-steward, pharmacist
and chemist, pharmacist, and medical purveyor, each
designation comprising one or more grades. Graduation
in pharmacy before appointment was first required in
1897.

Whatever his designation, the duties of a Service
pharmacist, until 1945, were both administrative and
_ professional. They were the technical administrative
officers of the Service, and at hospitals, quarantine sta-
tions, and the like, the senior pharmacist served as lay
superintendent, receiving general direction from the
medical officer in charge to whom he was responsible.
In these duties and assignments pharmacists have per-
formed services of marked importance in the fields of
hospital planning and operation; budget, personnel, and
supply management, physical maintenance of buildings,
ships, and equipment; sanitary inspection, fumigation,
rat-proofing of ships; research; and as disbursing and
contracting officers. As with all officers of the Service,
pharmacists are required to maintain their professional
fitness regardless of assignment. Despite their other
tasks, their functions have always included significant
pharmaceutical responsibilities.

Experience over many years has shown the expe-
diency and effectiveness of having a mobile corps of
pharmacists. For the proper performance of their re-
markably varied duties, they must have a broad under-
standing of the methods and functions of the Service, an
understanding gained only by training and background
of actual participation in field work. Thus, it is the prac-
tice to assign pharmacists, upon appointment, to the
smaller stations, and later transfer them to more im-
portant posts as they become familiar with the Service
and as their abilities develop. The availability of the
individual pharmacist for whatever duty might be as-
signed to him and the changes of duty and station have
the collective effect of creating a permanent mobile
corps of trained pharmacist officers who are essential to
effective operation of Service activities.

As the Service expanded through the years, phar-
macists have served at most of its field stations, includ-
ing hospitals,* quarantine stations, supply depots, re-
search stations, and the like, both in the United States
and abroad; and pharmacists have been detailed for
duty at the Headquarters of the Service where one or
more such officers have been on duty since 1894, when
by law the Surgeon General was authorized to detail
‘‘one hospital steward for duty in the Bureau.” A
number of pharmacists served on yellow fever epidemic
duty in charge of fumigation of houses, bedding, and
clothing. Frequently they were assigned to inspections
and administrative duties during various epidemic cam-
paigns.

* Originally named U.S. Marine Hospitals, changed in the 1950s to
U.S. Public Health Service Hospitals to better describe their identity.

APRIL, 1982

As may be expected in a Service primarily con-
cerned with medical care and public health, the function
dealing with the procurement and distribution of medi-
cal and related supplies is one of importance. The Sup-
ply Division, originally known as the Purveying Divi-
sion and later the Purveying Service, was one of the first
organizational segments established. The officer in
charge of the Purveying Division was designated the
Medical Purveyor. The Regulations of 1879 required the
Medical Purveyor to be a skilled pharmacist and his
compensation was the same as that of a surgeon of the
Service. This officer also served as a member of the
Advisory Board (or Service Board) whose function was
to consider matters referred to it relating to Service Per-
sonnel and the work of the marine hospitals. The first
Medical Purveyor was Dr. Oscar Oldberg, a pharma-
cist. He was appointed as Chief Clerk and Acting Medi-
cal Purveyor on July 10, 1877. On September 6, 1879,
the office of the Chief Clerk was abolished and Doctor
Oldberg was then appointed as Medical Purveyor.

The early regulations of the Service required candi-
dates for appointment as hospital-steward to be *‘suffi-
ciently ... skilled in pharmacy and bookkeeping to
perform duties of apothecary as well as steward,
whenever necessary.’ the requirement that hospital-
stewards be qualified in pharmacy was occasioned by
reasons of economy and operation efficiency.

The need for active Service participation and inter-
est in the revision of the Pharmacopeia of the United
States as a public health measure was early recognized,
and the Service has been regularly represented at each
decennial meeting of the Pharmacopoeial Revision
Convention held since the reorganization of the Service
in 1871. The 1950—1960 Revision Convention had, in its
membership, a Service pharmacist officer, George F.
Archambault, as one of the delegates in addition to
other Service representatives. This officer has also been
elected to membership in the Revision Committee to
serve on the five-man Prescription Board of the Phar-
macopoeia for the ensuing ten-year period. It is believed
that this is the second such recognition of a pharmacist
of the Service, Martin I. Wilbert, of the Division of
Pharmacology of the Hygienic Laboratory, having
served as a Revision Committee member for the U.S.P.
IX in 1910.

A betterment of special import to pharmacy resulted
from the approval on April 9, 1930, of the “‘Parker Act”’
which provided for the coordination of public health
activities of the Government. This law included provi-
sion for the appointment of pharmacists in the commis-
sioned corps with promotion up to and including the
grade corresponding to Army Captain. During the years
1930—1933, 11 pharmacists were commissioned pur-
suant to the Act. A further and substantial improvement
in the status and opportunity for pharmacists in the Ser-
vice occurred upon the approval of the Public Health
Service Act of 1944 (Public Law 410—78th Congress).
Under this Act the promotion limitation was lifted and
pharmacists may now be promoted to the Director

21

When
was the

last time

your
Insurance
agent
gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville, Meenas 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO

-BERNARD B. LACHMAN EVERY YEAR!

Usually for more than 20% of his premium.

BUNKY is one of the many Maryland pharma-
cists participating in the Mayer and Steinberg/
MPhA Workmen's Compensation Program—
underwritten by American Druggists’
Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS...
call or write:

_ Your American Druggists’ Insurance Co. Representative

AMERICAN
Armed DRUGGISTS’
INSURANCE

Please contact me. | am interested in receiving more

information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. O Call O Write.

grade corresponding to that of Army Colonel. Promo-
tions to the Senior and Director grades are made on a
selective and competitive basis for a limited and pre-
determined number of such positions. The first Pharma-
cist Director of the Service, Mr. Raymond D. Kensey,
was appointed temporarily by promotion in July, 1949.”

Current Activities (1982) of the Baltimore and
other PHS hospitals and the role of pharmacists:3

The Baltimore hospital, along with all other PHS
hospitals and clinics, was phased out in early 1982 under
the Reagan’s Administration government-wide budget
cuts. Today, no longer a federal facility it continues to
serve much the same type of patients as a non-profit
local institution known as Wyman Park Health System.

“The U.S. Public Health Service Hospital in Balti-
more as of July, 1981 was accredited for the last time
before its closure as a PHS hospital by the Joint Com-
mission on Accreditation of Hospitals. It provided ser-
vices within the city as well as in 11 states by means of
six satellite ambulatory care centers and 70 contract
care physicians. It was a division of the Bureau of
Medical Services of the Department of Health and
Human Services and was funded primarily by an annual
congressional appropriation.

The hospital served three categories of beneficiaries:

1. statutory federal beneficiaries including Ameri-
can seamen, PHS officers, Coast Guard and Na-
tional Oceanic and Atmospheric Administration
personnel;

2. other federal beneficiaries such as active-duty
and retired personnel in the uniformed services,
and their dependents; and

3. community beneficiaries such as Baltimore resi-
dents who come from medically underserved
areas.

The purpose of the Baltimore PHS hospital was to
| provide accessible, quality health care at reasonable
cost to the beneficiaries served. In trying to fulfill this
mission, the hospital was undergoing a major transition
from a traditional medical hospital to a comprehensive
health system facility. The comprehensive system em-
phasized ambulatory services, preventive as well as
therapeutic medicine, integration of multiple health and
social services, and support to and involvement with
community health programs.

National Health Emergencies

The participation in National Health Emergencies

was demonstrated most recently during the recent
Cuban refugee crisis, the Baltimore PHS Hospital sent 6
nurses, 16 physicians, 3 administrators, and several
pharmacists to various refugee centers from Florida to

3 Updated from an editorial by G. F. Archambault Appearing in
Drug Intelligence and Clinical Pharmacy Journal, July—Aug., 1981
issue entitled ‘‘In Defense of Eight Public Health Service Hospitals
and Their 29 Satellite Clinics.”’

APRIL, 1982

Pennsylvania. These health professionals were avail-
able on short notice, and along with staff from other
USPHS hospitals, demonstrated once again the capac-
ity of PHS commissioned officers to mobilize their tal-
ents to provide quality medical services in emergencies
anywhere in the country, in fact in the world, wherever
emergency health problems and epidemics arise.

Utilization

As to utilization, the hospital’s statistics for the past
five years (1976—1980) are quite revealing. In keeping
with modern health care trends, inpatient day care is
decreasing (from 15.9 to 9.7 days) and out-patient
(maintenance and other) care is increasing (from 104 303
visits to 127 515).

Pharmacy’s Role

As to the system’s pharmaceutical contribution to
patient care and national public health, the facts are
impressive. Back in 1953, one of the first national hos-
pital formularies was issued by the PHS hospitals,
‘“BASIC DRUGS—USPHS HOSPITALS AND CLINICS,” an
approach much copied by other hospitals throughout
the nation. Again, when the American Society of Hos-
pital Pharmacy residencies were in their infancy, PHS
hospitals were among the first to have approved residen-
cies. To date, via the residency system and its
offshoots, the pharmacy officer Commissioned Corps is
about 600 strong, with a chief pharmacist of flag rank
and pharmacist billets at the National Institute of
Health, Food and Drug Administration, Division of In-
dian Health, National Library of Medicine, and other
key PHS locations throughout the nation. In addition,
there are hundreds of well-trained hospital pharmacists
who have departed from PHS hospitals to pursue
careers in civilian hospitals, extended care facilities,
national and state associations, academia, and other
pharmacy and health administration leadership posi-
tions.”

During the latter years of the U.S.P.H.S. Hospital’s
existence, the pharmacy profession accepted its role in
clinical pharmacy, i.e., the nursing units had satellite
pharmacies and ‘“‘unit-of-use’’ doses were dispensed to
patients. The PHS pharmacists were in the forefront of
these endeavors. The Baltimore PHS Hospital was the
first of the federal hospitals (military and veterans) to
have pharmacists on nursing units full time, and among
the first to initiate the service of preparing and dispens-
ing ‘“‘unit-of-use’’ medication to each patient through
the pharmacy.

Publications

Two publications prepared by pharmacist officers
and others are of historical significance:

(1) ‘1953 BASIC DRUGS’’—USPHS Hospital’s
first Division Wide Formulary—Key Compilers were:

Clifton K. HimmelsBach, M.D. Medical Officer in

23

W Aowee magaynes, faeprrtaek books
BOL Gnd tome book Ws dee th

agatn one Oe if J

That's the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your Customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your Operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

THE MARYLAND PHARMACIST

charge of USPHS Out-Patient Clinic, Wash-
ington, D.C.

Jack Mordell, Pharmacist Director, Pharmacy Ser-
vice OPC Washington, D.C.

John Wilson, M.D., Clinical Director, USPHS Hos-
pital, Baltimore, MD

William Hanna, Chief, Pharmacy Service, USPHS
Hospital Baltimore, MD along with G. Halsey
Hunt, M.D., Assistant Surgeon General and
Assoc. Chief, Bureau of Medical Services, PHS
and George F. Archambault, Chief, Pharmacy
Branch, Division of Hospitals USPHS as coor-
dinators.

(2) THE SHIP’S MEDICINE CHART AND MED-
ICAL AID AT SEA—1978—a text book of ‘‘Medical
Advice by Radio’’—a service provided by the hospitals
and out-patient clinics of the USPHS. HEW Publication
No. (HSA) 78-2024. U.S. Government Printing Office,
Washington, D.C. This text is a revision of PHS publi-
cation number 9 ‘‘The Ship’s Medicine Chest and First
Aid At Sea,’ reprinted with additions and changes in
1955, Pharmacist Director Arthur W. Dodds (USPHS
Retired) was one of the key architects of the 1978 revi-
sion along with Richard Bertin, Pharmacist Director,
former Chief Pharmacy Branch, Div. of hospitals, cur-
rently on active duty at PHS CO headquarters in
Rockville, MD. G. F. Archambault, Pharmacist Direc-
tor played a key role in the 1955 revision as it related to
drug uses on merchant marine ships.

PART 2
The PHS Medical Supply Depot—Perry Point, MD
Brief History

The first period of a supply type operation for the
Public Health Service is indicated as 1892. This activity
was known as the U.S. Public Health Service Purveying
Depot and was located in Washington, D.C. The next
supply function of record was a Purveying Depot lo-
cated in New York City, New York in 1899, to provide
commonly used supply items for the then Marine Hos-
pital Service.

In the early part of the 20th century supply activities
were expanded with the establishment of a Purveying
Depot in North Chicago, Illinois and a Purveying Depot
at Perryville, Maryland. This latter establishment was
the precursor of the current PHS Supply Service Center
and was located on the grounds of U.S. Public Health
Service Hospital No. 42 at Perryville, Maryland.

By Executive Order of President Warren G. Hard-
ing, dated April 29, 1922, a number of PHS hospitals
including Hospital No. 42 were turned over to the newly
created Veterans Administration. In the same executive
order, President Harding specified that buildings and
supplies at the USPHS Purveying Depots at North

Note—I am indebted to E. Clifford Brennan, Pharmacy Director
for this special report on the Supply Center, George F. Archambault.

APRIL, 1982

Chicago, Illinois and at Perryville, Maryland be allo-
cated between PHS and VA on the basis of future
needs. This ultimately resulted in a 20%—80%
split—20% for PHS and 80% for VA.

As a result of the action ordered by President Hard-
ing all supply operations were consolidated into several
buildings on the ground of the Veteran’s Administration
Hospital, Perry Point, Maryland and renamed the PHS
Supply Station.

In 1953, when the Public Health Service became
part of the newly formed Department of Health, Educa-
tion, and Welfare the station was renamed the PHS
Medical Supply Depot. It retained this name until 1964
when it was redesignated as the PHS Supply Service
Center.

Available records demonstrate that from 1922
through 1978 the director at the facility was always a
PHS Pharmacist as shown in the following listing of the
pharmacists who have held that position:

Year Incumbent
19225 C. H. Bierman
1932 —1934 R. D. Kinsey
1935 W.H. Keen
1950— Thomas O. Armstrong
1937251939 Wor Keen
1940-1943 Charles H. Simpson, Jr.
1944 — 1945 Mr. Gohman
1946-1950 George B. Hutchison
1951-1964 Robert L. Capehart
1964-1978 Salvatore D. Gasdia

Commencing in October 1978 a determination was
made that the position of director of the facility should
be filled by a non-pharmacist civil service supply man-
agement officer. Serving as the director since that time
have been:

1978—1979
Febs1979=Oct 31979
Oct. 1979—Sept. 1980
Sept. 1980—Oct. 1980
Oct. 1980 to date

Harry O. Knutson (Acting)
Thomas W. Miller

Harry O. Knutson (Acting)
Wilmer J. Blackwell
Vacant

Since the death of the last Director, W. J. Blackwell,
in October 1980, the Center has been run by the Deputy
Director, Richard A. Moss, a PHS Pharmacist.
Concurrent with the decision that the position of
Center Director should be filled by a non-pharmacist
supply management officer, the position of Pharmacy
Advisor to the Center was created to provide expertise,
advice, and guidance on all matters pertaining to Phar-
macy. This position has been and is currently filled by
pharmacist E. Clifford Brennan since it was created.

Functions:

The PHS Supply Service Center is a full service
medical supply depot, providing pharmaceuticals and
other medical and dental supplies to approximately 895

25

federal medical facilities, including those of the Public
Health Service, Indian Health service, Department of
Justice, State Department, Coast Guard, Peace Corps,
Job Corps, and others.

Since 1950 it has operated a centralized pharmacy
service which has as its primary function the packaging
of unit-of-use dispensing size packages of common use
pharmaceuticals. This service has evolved to the point
where approximately 1.8 million units are packaged
annually in strict accordance with FDA Current Good
Manufacturing Practices Regulations.

In addition, the Center provides drug coding,
packaging, labeling, and distribution services for a
number of large scale government-sponsored clinical
trials including the Hypertension Detection and
Follow-up Program, the Multiple Risk Factor Inter-
vention-Trials, Beta-Blocker Heart Attack Trials, and
the Early Treatment of Diabetic Retinopathy Study.

Continued in May Issue

The Pharmacy and Therapeutics Committee at a monthly meeting
of the Baltimore USPHS Hospital. Members, left to right are:
James A. Hunter, M.D., chairman; Peter B. Drex, Dental Director;
G. K. Massengill, M.D.; Maud |. Larsen, Sr. Nurse Officer; Alvin
L. Cain, M.D.; Arthur W. Dodds, Pharmacy Director; Charles G.
Spicknall, M.D.; Robert L. Brown, Pharmacy Intern.

PERIERS

Dear Dave:

April 30— May 2, 1982 and November 3—7, 1982 are
two sets of important dates!

On April 30—May 2, the American Society of Con-
sultant Pharmacists will hold its 4th Midyear Conference
in Nashville, Tennessee at the Hyatt Regency Hotel.
This meeting will be held in conjunction with the
American College of Apothecaries’ Midyear Conference.
This will truly be a ‘‘noteworthy’’ event and a unique
display of pharmacy unity.

On November 3—7, ASCP will hold its 13th Annual
Meeting in New York City at the Sheraton Centre Hotel.
This meeting will continue ASCP’s tradition of offering
high quality continuing education.

As a service to your readers, please print these dates
in your publication.

A brochure on the Midyear Conference is enclosed.
For more information on either meeting, please feel
free to contact me.

Thank you for your assistance.

Sincerely,

R. Tim Webster

Executive Director

American Society of Consulting Pharmacists

26

ASHP Annual Meeting Offers Expanded
Continuing Education Opportunities

W ASHINGTON—Combining the annual House of Del-
egates Session and the opportunity for continuing edu-
cation, the 39th Annual Meeting of the American Soci-
ety of Hospital Pharmacists (ASHP), June 6—10, in

' Baltimore, the meeting offers something for everyone.

In addition to a general session each morning, con-
tributed papers in poster format and several new con-
tinuing education sessions are planned. All meeting ses-
sions are to be held at the new Baltimore City Conven-
tion Center.

Two clinically oriented features of the Annual
Meeting will be ‘‘Clinical Grand Rounds”’ and ‘‘Clinical
Consultation Sessions.’’ Grand Rounds will combine
interesting case reports with discussions of drug ther-
apy, and audience participation will be invited. Clinical
Consultation Sessions will be patterned after the
Curbside Consultations, so popular at the ASHP’s
Midyear Clinical Meeting, but will focus on therapeutics
solely. Registrants will have an opportunity to discuss
therapeutic dilemmas with well-known practitioners in
those areas.

‘It Works for Me,’ a new Annual Meeting feature,
is designed to be an idea exchange among registrants.
Useful forms, manuals, or hints for practice can be
shared during this session.

Information on Annual Meeting registration and ac-
commodations is available from ASHP headquarters on
request.

THE MARYLAND PHARMACIST

Peter P. Lamy, Ph.D., (left) Chairman of the Department of Pharmacy
Practice and Administrative Sciences at the School of Pharmacy
and Frank B. McGlone, M.D., (right) President of the American
Geriatrics Society, were CoChairmen of a special Symposium on
“Managing Medication in an Older Population: Physician, Phar-
macist and Patient Perspectives.” Harriet S. Frieze, (center) is the
Director of Professional Marketing for McNeil Consumer Products
Company, the sponsor of the Symposium.

Donald O. Fedder, B.S. Pharm, MPH, Assistant Professor in the
Department of Pharmacy Practice and Administrative Science
was elected Vice-Chairman of the National Council on Drugs. The
NCD is an independent, nonprofit body of experts drawn from the
academic, industrial, government and public health sectors, dedi-
cated to the improvement of drug therapy. Don, a Past President
of the M.Ph.A. has been representing the American Pharmaceuti-
cal Association on the NCD since 1976.

In addition, Don was recently elected to serve as Chairman of
the Health Care Industry Foundation’s Orthotic and Prosthetic
Examination Board.

APRIL, 1982

sa,

Estelle Cohen, Consumer member of the Maryland Board of
Pharmacy appeared on the Symposium program which was held
December 9-10, 1981 at the Westbury Hotel in New York City.

Ft a 5 sy

David P. Hoitwill will serve as sales representative for the Burroughs
Wellcome Co. in the Bethesda area of Maryland following an
intensive training program. David has a B.S. degree from the
Medical College of Virginia School of Pharmacy.

Janis M. Pulcini has been assigned to a Baltimore territory for The
Upjohn Company. She recently completed four weeks of training
at The Upjohn Company Learning Center in Kalamazoo, Michigan.
Janis is a graduate of Temple University.

ve

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

ACYCLOVIR:

Herpes simplex virus infections are the major cause
of death in patients who have received bone marrow
transplants. The infections start approximately eight
days after the procedure. Acyclovir was administered to
10 patients while another 10 served as controls. Seven
of the 10 controls contracted Herpes simplex viral in-
fections while none were seen in the treated group.
Acyclovir seems to inhibit viral replication and although
it may not eradicate latent infections, it does provide
effective prophylaxis against symptoms of reinfection.
N ENG J MED, Vol. 305, #2, p. 63, 1981.

BAGGIE THERAPY:

Patients with rheumatoid arthritis frequently com-
plain of pain in spite of drug therapy. Heat has been
used to help alleviate some pain, but a large group of
people seem refractory even to this procedure. Physi-
cians in Philadelphia have resorted to cryotherapy
utilizing ice cubes in plastic baggies. In some patients,
the use of this technique has led to reduction or com-
plete elimination of drug therapy. The “‘baggie’’ therapy
was most useful for pain in the knee. J Am Med Assoc,
Vol. 246, #4, p. 318, 1981.

PREDNISONE:

Large doses of glucocorticoids such as prednisone
can cause a loss of nitrogen from the body. This nega-
tive nitrogen balance may lead to muscle wasting, os-
teoporosis, and growth retardation. Nitrogen loss can
be minimized by increasing daily caloric intake and by
ingesting greater amounts of proteins. Ann Intern Med,
Voll 95 FF 2a pals 1981.

RADIOACTIVE IODINE:

After the accident at Three Mile Island, it became
more apparent that a safe method of enhancing the
excretion of radioactive I-131 was required. Studies
have always indicated that the body is unable to distin-
guish between various members of the halogen family,
e.e. chlorine, iodine, bromine, and fluorine. The renal
excretion of radioactive I-131 was shown to be en-
hanced by ingesting sodium chloride and/or using a di-
uretic. The best results were obtained in patients who
increased their water intake while using both the salt
and the diuretic agent. The therapy should be started
within two days after exposure to the radioactive mate-
rial. J Clin Pharmacol, Vol. 21, #5, p. 201, 1981

DIABETES MELLITUS:
Vascular complications of diabetes mellitus may be
caused by a variety of changes which are seen in pa-

28

tients with this disease. An abnormality has been found
to exist which may help explain the increased coagula-
tion of blood which is seen in some people with this
condition. A new technique has produced evidence
which suggests that erythrocytes adhere to the endo-
thelial cells of the vasculature to a greater degree in
diabetics than they do in the same tissue of normal vol-
unteers. Diabetic gangrene and diabetic retinopathy
may be partially due to this abnormality. N Engl J Med,
V Ole 303 Dalai aloo:

ACETAMINOPHEN:

Animal studies have produced data indicating that
acetaminophen is converted in the kidney to para-
aminophenol, a potent nephrotoxin. Although it has not
yet been determined to what extent this occurs in hu-
mans, it may be an explanation which could help ex-
plain the renal side-effects association with large doses
of the analgesic. J Pharmacol Exp Ther, Vol. 218, #1,
DalGlLOS is

DMSO:

Dimethylsulfoxide (DMSO) is an OTC product
which is used illegally as a remedy for arthritis. It has
been found to inhibit the metabolism of sulindac
(Clinoril). Patients using the unapproved analgesic
should be cautioned about possible problems which
may occur if they use both products. Am Med News,
Septs45p.21/.198 18

METHAQUALONE:

Methaqualone is a drug which is highly abused by
youthful drug users, but in many cases the tablets sold
as methaqualone contain other materials including PCP,
diazepam, or a variety of other depressants. Last year
the DEA confiscated fewer than 15 tons of illicit
methaqualone while over 30 tons have been seized by
the agency thus far this year. Much of the drug is im-
ported from the South American country of Columbia.
Studies have shown that most drivers who die as a re-
sult of a motor vehicle collision and who are under the
influence of drugs other than ethanol are under the in-
fluence of methaqualone. J Am Med Assoc, Vol. 246,
#8, p. 813, 1981.

MEPERIDINE:

Meperidine (Demerol) is a widely prescribed
analgesic which is metabolized by the liver to nor-
meperidine, a compound with central nervous system
stimulating activity. When using the analgesic chron-
ically, it is suggested that it be administered parenterally
because a significant amount of the drug will be con-

THE MARYLAND PHARMACIST

verted to the metabolite if it is administered orally. Pa-
tients with liver dysfunction, including cirrhosis, may
convert less meperidine to normeperidine because of
decreased function, but they are also more likely to ac-
cumulate the metabolite which is formed. Meperidine is
best used by the injectable route. Clin Pharmacol Ther,
Vol. 30, #3, p. 183, 1981.

ACETAMINOPHEN:

Patients using the antineoplastic agent adriamycin
were found to experience greater toxicity if they also
received the analgesic acetaminophen. Investigators
feel that the toxicity may be avoided by carefully timing
the administration of the analgesic. More work is being
done to learn about the mechanism of this interaction.
Am Med News, September 4, p. 17, 1981.

LITHIUM:

The effects of the lithium ion on the adrenergic
nerve ending was studied using animal tissues. It was
noted that the neuronal uptake of norepinephrine is en-
hanced at therapeutic lithium concentrations thus at-
tenuating the response of the adrenergic nerve ending to
electrical stimuli. Toxic concentrations of the ion are
capable of inhibiting the activity of the enzyme
monoamine oxidase. J Pharmacol Exp Ther, Vol. 218,
#2, p. 309, 1981.

BONE NECROSIS IN DIVERS:

Aseptic bone necrosis is a condition seen with
greater frequency in commercial divers than in the gen-
eral population. It does not occur in those divers who
have remained above depths of 30 meters, but its fre-
quency increases to approximately 22% in those who
have descended to 300 meters. Regular radiographic
skeletal surveys are recommended for those who fit into
the high risk group. Lancet, Vol. II, #8243, p. 384,
1981.

MINOXIDIL:

Minoxidil is an effective antihypertensive agent
which may produce an increase in cardiac activity.
Beta-adrenergic blocking agents such as propranolol
(Inderal) can be used to offset these effects, but they
may be contraindicated in patients with compromised
respiratory function. Investigators have found that
clonidine (Catapres) can be used as a substitute for the
beta-adrenergic blocking agents thus eliminating the
side-effects of these drugs on the respiratory system
while still controlling the activity of the heart. Clin
Pharmacol Ther, Vol. 30, #2, p. 158, 1981.

DIAZEPAM:

The kinetics of diazepam (Valium) have been inves-
tigated in both sexes and in various age groups. It has
been suggested that the greater potency of the drug in
elderly people is partially due to the fact that the drug is
highly bound to plasma protein and elderly patients

APRIL, 1982

have less protein-binding capacity. In addition it was
noted that the volume of distribution of the ben-
zodiazepine derivative was greater in females than in
males and the total clearance of the drug was higher in
women than in men. Pharmacology, Vol. 23, #1, p. 24,
1981.

FLECANIDE:

Flecanide is an orally effective antiarrhythmic agent
which has been found to be useful in treating ventricular
arrhythmias. The drug is highly effective in most people
and was well tolerated. It has a long half-life in the body
and thus may be administered less frequently than other
agents used for the same indications. The drug is being
distributed by Riker Laboratories for investigational
use. N Engl J Med, Vol. 305, #9, p. 473, 1981.

ACID SECRETION:

Drinking coffee can cause heartburn and gastroin-
testinal disturbances. In order to determine the role of
caffeine on acid secretion and gastrin release, decaf-
feinated coffee was administered to a group of volun-
teers. Decaffeinated coffee produced as much acid re-
lease as did regular coffee, and thus the authors have
concluded that the material responsible for this release
is not caffeine. They are not certain exactly what causes
the stimulation. J AM MED A, Vol. 246, #3, p. 248,
1981.

VERAPAMIL:

The new drug verapamil (Isoptin) has been shown to
be effective in terminating paroxysmal supraventricular
tachycardia and in reducing ventricular response in pa-
tients with atrial fibrillation. The major complaints from
patients taking the drug include initial hypotension and
bradycardia. Chronic therapy produces constipation,
nausea, dizziness, headache. and ankle edema. DRUG
THER, Vol. 11, #7, p. 44, 1981.

ARTHRITIS:

Patients With arthritis were studied to determine the
concentration of endorphin in their serum. It was noted
that patients with this condition had lower levels of the
hormone than did a group of matched controls. Pain is
associated with arthritis, and since patients with arthri-
tis have generalized metabolic deficiencies, they may
produce less endorphin than normal and thus would ex-
perience more pain and inflammation. J AM MED A,
Vol. 246, #3, p. 203, 1981.

MOXALACTAM:

A new third generation cephalosporin derivative,
moxalactam, has been shown to be effective against
Pseudomonas aeruginosa, Hemophilus influenzae, and
anaerobic bacteria such as Bacteriodes fragilis. The
drug has a half-life similar to that of cefazolin and thus
may be administered less frequently than other antibi-
otics. Several other agents are being investigated.
Moxalactam (Moxan) is being manufactured by Eli Lilly
and Co. CLIN PHARM, Vol. 30, #1, p. 86, 1981.

29

Perspectives in Pharmacy

Patient
Drug.

Information

Presented
in the interest of
better-informed
pharmacy

Neil L. Pruitt, R.Ph., President
National Association of
Retail Druggists

“The delivery of health care in our communities is
changing. Traditional institutions are giving way to home
health care and outpatient clinics. Handicapped persons with
their special needs for durable medical equipment and health
supports and appliances require personal attention. The
increase in Over-the-counter products that were once
prescription-only means that
more customers will require
counseling on their use. An
increasing drug-dependent elderly
population will rely more than
ever on the professional advice of
their pharmacists.

“Patient counseling will
become more important than ever
before because of the hosts of
different populations we are seeing
in our stores— the handicapped,
the elderly, the teenager who has
more money to spend on
cosmetics, the consumer who
wants to know about the efficacy of the drugs he or she
is taking.

“Talking to our customers gives us a unique marketing
advantage because we know who they are and what they
want. Service is, indeed, one of our keys for survival.”

Neil L. Pruitt, R.Ph

Dorothy L. Smith, Pharm.D.
Director of Clinical Affairs
American Pharmaceutical Association

“The pharmacist has an exceilent opportunity to test the
patient's recall of the information provided by the physician,
to make the prescription instructions readily understandable,
and to reinforce the patient’s faith in the prescribed therapy.

Part of a continuing series on today’s pharmacy

“The type and amount of
information required will vary
with the specific needs of the
patient. But generally, patients
want enough information to help
them complete the therapy as
easily and as safely as possible.

“Almost all patients will have
questions about applying the
drug regimen to their own
schedules. They are willing to
modify their daily activities to
accommodate a dosage schedule
if they understand why the
changes are best for them. But these questions can be
answered only on an individual basis.

“Handing the patient a full disclosure sheet does not
effectively help ‘educate.’ In fact, a long list of potential
adverse effects may even convince a patient not to take
the medication.

“Every effort must be made not to frighten the patient.
Basically, the role of the pharmacist is to help a patient use
drugs most effectively and with the least anxiety.”

Dorothy L. Smith, Pharm.D

Reprinted from American Pharmacy, Vol. NS 21, No. 7, p. 382

John F. Schlegel, Pharm.D., M.S.
Executive Director
American Association of Colleges of Pharmacy

“Most pharmacy professionals
recognize the importance of
communication skills. Indeed,
depending on one’s particular
perspective, personal pharmacy
service that emphasizes patient
education can be a source of
immense satisfaction, enhanced
professional image, increased
patronage, and improved health
care through better under-
standing and use of medicines.

“Influences both inside and
outside the profession point
toward a resurgence of personal
contact between the pharmacist and the patient. The public’s
‘right to know’ cannot responsibly be denied. The problem
has been in finding time in the pharmacy student’s busy
curriculum for proper communication skills training.

“For the past several years, colleges of pharmacy have
been increasing the quantity and quality of training in this
area, and greater attention is being paid to the influence of
personality types on professional motivation.

“In the future, the 1980's will likely be described as the
‘Communications Era’ in pharmacy. The profession has made
significant advances, but there is still a need for more
change.”

John F. Schlegel, Pharm.D., M.S.

Lilly Eli Lilly and Company

Indianapolis, Indiana 46285

100902

The views expressed are the authors’ and not necessarily those
of Eli Lilly and Company.

© 1981, ELI LILLY AND COMPANY

Classified Ads

Classified ads are a complimentary
service for members.

For Lease—Jumpers Mall, Ritchie Highway between Glen

Burnie and Severna Park. Unusual opportunity for inde-
pendent druggist to have only drug store at this well es-
tablished shopping center. Up to 4,000 square feet avail-
able between supermarket and K mart. Supermarket had
1981 sales of over $400 per square foot, yet has no pharm-
acy and only carries a limited selection of health and
beauty aids, only one side of a 50’ aisle. Total center sales
exceeded $156 per square foot, a 36% increase over 1980.
Our primary trade area includes 65,000 households, with
195,000 population. 71% visit the mall on a regular basis
at least once a month. Call Chris or Randy at Developers
General Corporation weekdays 9 to 5. 301-821-8500.

MARYLAND

PHARMACEUTICA\
ASSOCIATION

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

a
»
A ‘yp vat L

ACTUAL SIZE

Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the ‘“P.D.” designa-
tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
Maryland Pharmaceutical Assn.
650 W. Lombard St.
Baltimore, Md. 21201

APRIL, 1982

We at SELBY DRUG COMPANY
attribute our rapid growth and success
to our ability to make changes. These
changes are made rapidly, when and
where they are needed!!

The SELBY DRUG management

team evaluates sources of supply twice
a year.

DO YOU?????

Maybe it’s time for you to evaluate
your present drug wholesaler.

For information on our Full Line pro-
gram, please call person-to-person collect
to:

Wallace Katz
Senior Vice President

SELBY DRUG COMPANY

633 Dowd Avenue
Elizabeth, NJ 07201
(201) 351-6700

CENTENNIAL MARKET

“Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

* Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

* The M.Ph.A. is offering to the public and its members
the USP publication, ‘About your Medicine.” This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available— ‘About your
High Blood Pressure Medicine’’—$3.00 each plus $1.00
postage and handling.

*The Pharmacy Art Print ‘“Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

* Centennial Apothecary Jars with the Association's
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

31

\

More than just a book of standards—

¢ Authoritative, legally-enforceable standards of
strength, quality, purity, packaging and labeling
governing the articles used in your practice. A drug
identified as USP must comply with the standards
set forth; otherwise the drug may be considered

—USP XX-NF XV is an essential

adulterated or misbranded. / reference book.

¢ Dependable reliable standards that have assumed
unprecedented significance in this era of drug USP XX-NF XV contains a variety of requirements
product selection—an era in which the pharmacist and information for the day-to-day practice of
should be aware of what USP basically requires pharmacy.
of a multi-source drug product. ¢ Requirements for drug stability and storage conditions

¢ Requirements for dispensing containers and packaging
\ materials, including unit-dose packages and child-
resistant containers

¢ Standards kept current by a continuous revision
process.

¢ Dissolution standards of obvious interest to
practicing pharmacists.

¢ Special precautions in dispensing

¢ Federal antibrotic regulations

¢ Controlled drug regulations

And USP XX-—NF XV is supplemented annually to
keep your copy up to date. For your convenience the
Supplements are cumulative, containing all the revisions
published in previous Supplements. The current revision
of the official compendia, USP XX—NF XV, was
published in 1980, and the 441-page Third Supplement
Me published in February, 1982.

\)

Maryland Pharmaceutical Association
650 W. Lombard Street
Baltimore, Maryland 21201

Enclosed is my check or money order for $
payable to USPC, for:

> _ USPEX X= NEOX Vi.

_____ USP XX-NF XV, with Supplements, $100*
_____ Third Supplement to USP XX-NF XV, $8*
_____ Third and all future Supplements to USP XX—NF XV, $27*

_____ 1983 USP Dispensing Information (2 volume set), $37.95T

Name:

Address:

City: ee ee ne

*Pennsylvania residents add 6% sales tax. tMaryland residents add 5% sales tax.

;

THE
MARYLAND
PHARMACIST

Official Journal of
The Maryland
Pharmaceutical
Association

May, 1982
Vol. 58
No. 5

Spring Regional Pictures

History of USPHS Pharmacy

— George F. Archambalt

Employer—Employee Relations Forum

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746

VOL. 58

MAY, 1982

CONTENTS

3 President’s Message — Philip H. Cogan
4 Dedication of Plaque Commemorating 100 years
9 Employee — Employer Relations Forum

12. A Brief History of USPHS Pharmacy in
Maryland — George F. Archambalt

19 Medicaid Fraud Prosecutions

20 Picture page

Abstracts

oo
DEPARTMENTS

27 Letters to the Editor
31 Calendar

31 Classified Ads

ADVERTISERS
17 Abbot Burroughs 22 Mayer and Steinberg
30 Wellcome 28 Parke Davis
25 District Paramount Photo 24 Pfizer
8 The Drug House 6—7 Roche
14 Lederle 20 Sandoz
11 Eli Lilly and Co. 31 Selby Drug Co.
16 Loewy Drug Co. 26 Upjohn

18 Maryland News Distributing 10 Youngs Drug Co.

REE ARS SEER SS Sb SRE SES RS SN SIS IETS ES SR SS AL SY SS ES SP IE EE IEE, I ES SW IP A IIE PT CT GSS,

Change of address may be made by sending old address (as it appears on your journal) and
new address with zip code number. Allow four weeks for changeover. APhA member —
please include APhA number.

The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar-
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as
part of their annual membership dues. Entered as second class matter at Baltimore, Mary-
land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baitimore, Maryland 21201.

NO. 5

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor
ABRIAN BLOOM, Photographer

Officers and Board of Trustees

1981-82

Honorary President

JOHN C. KRANTZ, JR., Ph.D. — Gibson Island
President

PHILIP H. COGAN, P.D. — Laurel
President-Elect

MILTON SAPPE, P.D. — Baltimore
Vice-President

IRVIN KAMENTZ, P.D. — Baltimore
Treasurer

MELVIN RUBIN, P.D. — Baltimore
Executive Director

DAVID BANTA, M.A. — Baltimore

Executive Director Emeritus
NATHAN GRUZ, P.D. — Baltimore

TRUSTEES

SAMUEL LICHTER, P.D. — Chairman
Randallstown

WILLIAM C. HILL, P.D. (1984)
Easton

GEORGE C. VOXAKIS, P.D. (1984)
Baltimore

BARBARA BARRON, P.D. (1983)
Rising Sun, Maryland

STANTON BROWN, P.D. (1982)
Silver Spring

RONALD SANFORD, P.D. (1982)
Catonsville

DUDLEY DEMAREST, SAPhA (1982)
Baltimore

EX-OFFICIO MEMBER
WILLIAM J. KINNARD JR., Ph.D. — Baltimore

HOUSE OF DELEGATES
Speaker
MADELINE FEINBERG, P.D. — Kensington

Vice Speaker
JAMES TERBORG, P.D. — Aberdeen

MARYLAND BOARD OF PHARMACY

Honorary President
I. EARL KERPELMAN, P.D. — Salisbury

President
BERNARD B. LACHMAN, P.D. — Pikesville
ESTELLE G. COHEN, M.A. — Baltimore
LEONARD J. DeMINO, P.D. — Wheaton
RALPH T. QUARLES, SR., P.D. — Baltimore
ROBERT E. SNYDER, P.D. — Baltimore
ANTHONY G. PADUSSIS, P.D. — Timonium
PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

THE MARYLAND PHARMACIST

MAY, 1982

President's Message

Illegible handwriting of physicians has always been the brunt of jokes,
but if you are a pharmacist in a high volume environment, it is not very funny.
Poorly written prescription orders cause a variety of ramifications whether you
are in a hospital or community practice. First of all, with the number of sound
alike drugs increasing, unless the prescription is written legibly, we run the risk
of dispensing the wrong drug. Granted, only a small minority of physicians
refuse to write out prescription orders neatly, nevertheless, there is no excuse
for their cavalier attitude toward handwriting.

Pharmacists should not fill any prescription order where there is any
doubt as to what the request is. Where there is any ambiguity, the pharmacist
must contact the prescriber. Of course the patient will ultimately suffer from
this lack of consideration by physicians.

According to the Board of Pharmacy and representatives of the Division of
Drug Control, the biggest problem is with signatures. There is a special problem
with hospital prescription orders, where the name of the physician is not printed
on the form. Some hospitals have been known to inform their staff that the law
provides for a severe fine if their name is not legible. For drug control pre-
scriptions the law is very specific that the name of the prescriber must be
stamped, printed or typed. Also, section 187b item 18 at the Maryland Food,
Drug and Cosmetic Act prohibits, ‘‘prescribing any drug without clearly iden-
tifying the name of the prescriber or the prescription form and dispensing any
drug based on a prescription form which lacks the name of the prescriber.”’

The Board of Pharmacy is grappling with the legibility issue, if you have
any suggestion to help them get prescribers to write more legibly, they would
appreciate hearing from you. In the meantime, I have asked the Maryland
Hospital Association to inform their members that a problem exists.

Philip H. Cogan,

President

Dedication of Plaque
Commemorating 100 Years of
Maryland Pharmaceutical
Association

Today we honor the memory of two outstanding
Marylanders who charted the course of the profession
of Pharmacy for many years, David Stewart and Wil-
liam Procter are names nearly forgotten by practicing
pharmacists in this time, but they were both central
figures in the fledgling profession as it began to take root
and grow in the New World, particularly in Baltimore
and the surrounding cities and states.

Therefore it is appropriate that we all take a moment
to reflect on who these men were and what they did, just
as it is necessary for us in the 100th year of the Mary-
land Pharmaceutical Association to reflect on what we
as pharmacists have done.

First, thanks to Professor Ben Allen, we all know
more about David Stewart from his excellent article in
the February 1982 issue of the Maryland Pharmacist,
Stewart was 69 years of age when the M.Ph.A. was
organized in 1882, so we suspect that he took little part
in the actual meetings, although his teaching undoubt-
edly contributed to the interest of pharmacists in Mary-
land to organize themselves.

Stewart died in 1899 and by that time had ac-
complished more than many of us hope to complete in
our lifetimes. He was present when the Maryland Col-
lege of Pharmacy was founded; he was a member of the
Board of Examiners; he actively participated in the
teaching and was appointed Professor of Pharmacy in
1844, Stewart, being a chemist and pharmacist, had also
taken a degree in Medicine two or three months prior to
this appointment. Thus, Stewart becomes the first rec-
ognized Professor of Pharmacy in the United States. He
remained the professor until he resigned in 1846, but
continued as Secretary of the College, David Stewart
practiced pharmacy in his store at the southeast corner
of Hanover and Camden Streets. He was active in civic
affairs, being a member of the Baltimore City Council
(1835—37), School Commissioner (1936), Ruling Elder in
the First Presbyterian Church (1838) and a member of
the State Senate (1840).

Stewart was Inspector of Drugs for the Port of Bal-
timore from 1850 to 1853. In 1853, the Baltimore Patho-
logical Society was formed by Stewart and eight other
doctors. His term of office in Annapolis caused him to
return there in 1855 as Professor of Chemistry and Nat-

4

The 1982 Spring Regional meeting was held March 28, 1982, in
the Kelly Building. William Skinner (left), Chairman of the Centen-
nial Celebration Committee, presents a plaque honoring David
Stewart and William Proctor to Philip Cogan, (right) M.Ph.A.
President. The Dedication remarks given by Dr. Skinner are re-
printed on this page.

Following the Spring Regional meeting, members and guests
posed on the lawn of the Kelly Building next to the new identifica-
tion sign unveiled at the meeting.

Pictures Courtesy of District-Paramount Photo

THE MARYLAND PHARMACIST

i —
The Spring Regional Meeting featured an “Issues Forum” moder-
ated by Speaker of the House Madeline Feinberg. Presentors
were: (from left to right) Ronald Telak, Past President of the
MSHP; Martin Mintz, Executive Director of the Maryland Chapter
of the American Society of Consulting Pharmacists; Bernard
Lachman, President of the Maryland Board of Pharmacy; Wil-
liam J. Kinnard, Jr., Dean of the School of Pharmacy; William
Grove, President of the MSHP; and Philip Cogan, President of the
M.Ph.A.

CPHARMACEONGAL
c ASSOCIATION

State Society of Pharmacists

KELLY MEMORIAL BUILDING
B. Ofive Cole Museum he
Public ars by Appointment

Board members are shown with the new sign which was a special
project of the Centennial Celebration Committee to help alert the
public to the availability of the B. Olive Cole Pharmacy Museum.

ed

as “ * “ : P.
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President Cogan reads a message from the Governor and proc-
lomations from the Maryland House of Delegates and Senate.

MAY, 1982

Ze * E y ¥ $ , a “ee ) = 3 é

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William Hawk makes a point during the open discussion section
of the Issues Forum.

ural Philosophy at St. John’s College. Stewart returned
to Port Penn, Delaware in 1862 and in 1872 the Mary-
land College of Pharmacy conferred the Doctor of
Pharmacy degree on him.

William Procter, Jr. was born in Baltimore as the 9th
son of Izak and Rebecca Procter, a Quaker family, in
1817. Procter died in 1874, so he too had little direct
participation in the formation of the Maryland Phar-
maceutical Association. Procter however gained the
appelation of ‘‘Father of American Pharmacy’’ because
of the activities of his career. He became dean of the
Philadelphia College of Pharmacy in 1865; editor of the
American Journal of Pharmacy in 1867; Secretary of
American Pharmaceutical Association in 1852; Profes-
sor Pharmacy 1846; Editor of Practical Pharmacy in
1849; participated in the 3rd ed (2nd revision) of the
U.S.P. and was elected to USP Committee of Revision
in 1850.

Time does not permit the listing of all of Procter’s
activities, suffice it to say that although he left Balti-
more at age 14 to learn the apothecary trade, he re-
mained interested in his birthplace and the Pharmacy
profession there.

The Maryland College of Pharmacy awarded Procter
the Doctor of Pharmacy degree in 1871 on the same
occasion that it awarded David Stewart a degree.

Therefore, it is fitting in this 100th year of our as-
sociation that we take time out of this meeting to reflect
on the memory of these two imminent pharmacists from
Baltimore, Maryland, and to remember them as men
who contributed so that we have today a more useful
profession of pharmacy to serve the public health.

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8 THE MARYLAND PHARMACIST

AD NO. 104-A

EMPLOYEE—EMPLOYER
RELATIONS FORUM

The purpose of the Forum is to deal creatively with the issues in Maryland Pharmacy employer and
employee relations. This Committee of the Association is made up of individuals from a wide variety
of practice settings. We are asking for input on current employment issues from all segments of the
profession. The Forum will act as a “sounding board’’ on these issues and will provide some

ombudsman activity.

Suggested Employment Agreement
Considerations

The Employer-Employee Relations Forum feels that
a clear understanding of the Employment Relationship
is necessary to prevent misunderstanding by either the
Employer or Employee Pharmacist. The Forum feels an
agreement between the Employer and Employee Phar-
macist, whether it be an informal agreement or highly
structured formal contract, is necessary for a mutually
satisfying relationship.

The Forum therefore presents, as a Service to the
members of the Maryland Pharmaceutical Association,
a list of job-related items which should be considered
and discussed at the time of employment by the
employer and employee pharmacist.

1. Job Description. The Pharmacist should have a
clear understanding of the duties, responsibilities, and
authorities that will be expected as part of the employ-
ment. In some cases employer may wish to provide a
‘*Policy Manual”’ that will outline operating procedures
for the employee pharmacist. This will allow both
employer and employee to measure performance
against an established criteria.

2. Length of Employment. In most instances the
length of employment will be indefinite. However, the
following should be discussed:

. Length of the ‘‘Probationary Period’? if any.

. The duration of the agreement, if any.

. The conditions under which the agreement
may be re-negotiated.

3. Compensation. As part of the compensation
package, some of the following may be considered:

. salary (hourly or weekly)

. overtime

. Bonus and or profit sharing
The method of arriving at such a figure should
be pre-determined and agreed upon.

4. Benefits. Without intending to be all inclusive the
following list of possible employment benefits is pro-
vided and if available should be clearly understood:
vacation
. sick leave
professional society membership
. continuing education
health insurance
. Life insurance
professional liability insurance
income protection insurance
. retirement plan
. stock purchase options
. personal purchases—employee discounts
. professional attire
. court time (jury duty, witness)

. funeral leave

5. Schedule. While allowing for flexibility, an un-
derstanding should be reached regarding the general
hours to be worked, shifts, and procedures for request-
ing alterations of the standing schedules. In addition, it
is helpful to know specifically which day will be consid-
ered holidays.

6. Practice Limitation. In some practices an
employee may wish to stipulate that the employee
pharmacist may not work for another employer in a
relief or part-time position.

7. Arbitration of Disagreements. It may be helpful
to provide a description of the manner in which dis-
agreements can be resolved. The employer-employee
relations forum will not serve as a formal arbiter, but is
available to make recommendations for arbitration.

8. Termination. The agreement may be formal or
informal, but the amount of notice (and or severence
pay) should be specified.

In conclusion, we cannot emphasize enough the im-
portance of regular, open communication between the
employer and employee.

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10 THE MARYLAND PHARMACIST

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develop new products, such as biosynthetic human insulin, and
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MAY, 1982 I]

A Brief History of USPHS
Pharmacy in Maryland

George F. Archambalt

Continued from April Issue

PART III

Pharmacy Service, Clinical Center,
NIH—Bethesda, MD*

History

Back in 1951, there appeared in the January —Feb-
ruary issue of the Bulletin of the American Society of
Hospital Pharmacists, an article by John C. Trautman,
M.D. Director, the Clinical Center, Jack Masur, M.D.,
Chief of the Bureau of Medical Services, USPHS and
George F. Archambault, Ph.C., D.Sc., LL.B., Chief of
the Pharmacy Branch, Division of Hospitals of USPHS
(Federal Security Agency) PHS, an article entitled
‘Clinical Center, NIH—Facilities for Pharmaceutical
Services.’ The paper closes with these two (2) para-
graphs:

(1) ‘‘It is expected that the Clinical Center will be
completed in 1952 and patients admitted the early part
of 1953. Thus will begin the writing of another chapter in
the history of man’s attack on the disease groups which
constitute major causes of death and disability in the
United States. The relationship of physician-pharma-
cist-patient assumes a special importance when treating
and studying patients with long-term illnesses and in-
fectious diseases. The clinical-pharmaceutical research
problems that will be encountered in this pharmacy
in the allied fields of basic pharmacology, toxicology,
posology, pharmacognosy, biochemistry and stochio-
metry will be varied. These, along with the general
problems of hospital pharmacy management and oper-
ation will challenge the ingenuity and resourcefulness
of skilled hospital pharmacists.’

(2) ‘‘Acknowledgements. The National Institutes of
Health gratefully acknowledge the many contributions
of individuals of the pharmacy profession who so will-
ingly served as consultants in the planning and design-
ing of this pharmacy. Special mention should go to
Mr. John Murphy, chief pharmacist at the Mas-
sachusetts General Hospital in Boston, Mr. Don
Francke, chief pharmacist of the University Hospital at

+ | am indebted to Dr. Joseph F. Gallelli for much of the material in
Part I1I—Pharmacy Service, Clinical Center, NIH USPHS.—GFA

12

the University of Michigan, Ann Arbor, Mr. Arthur
Dodds, chief pharmacist of the Lynn General Hospital
in Lynn, Massachusetts, Mr. Milton W. Skolaut, chief
pharmacist at the U.S. Marine Hospital, Staten Island,
and former assistant chief pharmacist at Johns Hopkins,
Dean H.C. Newton of the Massachusetts College of
Pharmacy, Boston, Mr. Grover C. Bowles, chief phar-
macist of the Strong Memorial Hospital at Rochester,
New York, Dean E. R. Serles of the College of Phar-
macy of the University of Illinois, and Mr. Ernest J.
Simnacher, chief pharmacist of the U.S Public Health
Service Hospital in Lexington, Kentucky.

A Bit About the Two Directors of the Clinical Center’s
Pharmacy Service One Serving from 1952 to 1970, the
Other 1970 to Date Chief Pharmacist, Milton Skolaut,
Pharmacy Director Commissioned Officer, USPHS—
1952-1970.

Mr. Skolaut entered the Corps in 1949, as chief
pharmacist at the PHS Hospital, Staten Island, N.Y.

He received a B.S. in Pharmacy from the University
of Texas in 1941, and served his hospital pharmacy in-
ternship at The Johns Hopkins Hospital in Balti-
more, MD.

Mr. Skolaut became internationally known for his
innovations in the development of a complete phar-
maceutical service that would meet the needs of a mod-
ern research hospital.

Initiates New Services

During his CC career, Mr. Skolaut initiated a service
for developing drug dosage forms and suitable assays
for many investigational drugs; and a radiophar-
maceutical service emphasizing product development in
addition to assays and proper controls.

His department was one of the first hospital phar-
macies to also offer intravenous additive service
round-the-clock.

Other innovations included: pre-packaging drugs
and sealing the package to assure reliability; using plas-
tic containers for packaging when practicable, and using
lot and batch numbers on labels of all central supply
items.

THE MARYLAND PHARMACIST

Also, the Department established guidelines for
standards for preparation of I.V. admixtures.

1970 to Date
Chief Pharmacist, Joseph F. Gallelli, Ph.D.

Dr. Gallelli joined NIH in 1961 as chief of the CC
Pharmacy Department’s Pharmaceutical Development
Service. Earlier, he had been an investigator with
Wyeth Institute for Medical Research in Radnor, Pa.,
and an instructor at Temple University’s School of
Pharmacy.

He earned his B.S. degree at Long Island Universi-
ty’s Brooklyn College of Pharmacy in 1957, and re-
ceived his M.S. and Ph.D. degrees from Temple Uni-
versity.

The Clinical Center Today

The Clinical Center today (1981) is a 14-story, 564-
bed research hospital located in Bethesda, Maryland. It
is part of the National Institutes of Health, the Federal
government’s primary medical research agency.

The Clinical Center was specially designed to bring
scientists working in 1,100 laboratories into close
proximity with clinicians caring for patients, so scien-
tists and physicians may collaborate on medical prob-
lems.

The primary mission of the Clinical Center is to pro-
vide the specialized forms of hospital care necessary for
Institute studies.

Patients, upon referral by their physicians, are ad-
mitted to clinical studies conducted by NIH Institutes
concerned with cancer, allergy, and infectious diseases;
arthritis, metabolic and digestive diseases; child health
and human development; dental disorders; diseases of
the eyes; heart, lung, and blood diseases; neurological
and communicative diseases and stroke; and mental and
emotional illnesses.

About 15 percent of the patients are ‘“‘normal vol-
unteers’’ healthy persons who provide scientists with an
index of normal body functions against which to mea-
sure the abnormal. Normal volunteers come under such
varied sponsorship as colleges, civic organizations, and
religious groups.

The Pharmacy Department’s Missions and Goals
as of 1981

The mission of the Pharmacy Department is to pro-
vide comprehensive, properly coordinated, phar-
maceutical services of the highest quality to patients
and staff of the Clinical Center in support of biomedical
research.

To accomplish this mission, the goals are to provide:

1. Effective drug distribution systems and clinical
pharmacy services which support quality patient
care.

MAY, 1982

2. Accountable, documented clinical pharmacy
practice.

3. Pharmacy education programs which augment
clinical pharmacy practices.

4. A pharmacy research program which improves

patient care.

The Organizational Set-up of the Pharmacy
Services Under Dr. Gallelli

The Pharmacy Department in the Clinical Center
consists of the Office of the Chief, Pharmaceutical Pro-
curement and Control Section, Pharmacy Service Sec-
tion, and the Pharmaceutical Development Service
Section. Present staff consists of approximately 65
full-time and part-time employees, 30 of whom are
pharmacists.

The Pharmacy Department provides a 24-hour com-
prehensive pharmacy service both for inpatients and
outpatients. The majority of distributive services are
provided from the central pharmacy. These include: 1)
the purchase of drugs and supplies, 2) narcotic control
and distribution, 3) the manufacture of pharmaceutical
preparations, 4) a unit dose distribution system for all
nursing units, 5) an IV admixture service for all units,
and 6) the dispensing of drugs to outpatients.

The Department has an entire section consisting of
11 people for the purpose of assisting physicians in their
clinical research. This staff formulates, develops, and
assays investigational drugs, performs analysis, sets up
blinded studies, and is a national source of investiga-
tional drug information. It is analogous to a phar-
maceutical manufacturing company that prepares cus-
tomized investigational drug products for patient use.

The pharmacy provides a clinical pharmacy service,
staffed by pharmacists with advanced specialty training.
The clinical pharmacists routinely assist physicians in
designing and evaluating drug regimens of patients and
routinely monitor and assess drug regimens and other
patient parameters to assure proper and rational drug
therapy. Additionally, staff pharmacists are required to
participate in the clinical program through rotations
which require daily rounds of assigned nursing units for
the purpose of providing discharge counseling, drug
therapy consultation, and inservice education.

In order to serve the clinical research needs in drug
therapy monitoring, the pharmacy has established a
Clinical Pharmacokinetic Research Laboratory and a
consultative service. This is a service laboratory for all
institutes which determines and monitors drug levels in
patients and interprets the response of a patient to a
given regimen.

The use of investigational drugs is an important as-
pect of Clinical Center research. It is the formulation,
development, control, assay, dispensing, and clinical
monitoring of investigational drugs that differentiate the
Clinical Center’s programs from all other hospitals in
the country.

13

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THE MARYLAND PHARMACIST

PART IV
PHS Pharmacists at FDA in Maryland$

It is likely that pharmacists, or at least people who
had been trained in pharmacy, were members of the
staff of the Food and Drug Administration from its early
days, although it is unlikely that one will find few if any
listed on the roles with position titles of pharmacist.
With the advent of the Civil Service Commission and its
classification standard for pharmacists it was econom-
ically as well as occupationally very difficult for phar-
macists to be identified as such in any kind of Federal
service which included non-traditional roles. In other
words, if pharmacists were not compounding and dis-
pensing it was unlikely that the job could be classified as
a pharmacist position. Later certain kinds of jobs for
people who had certain functions related to the evalua-
tion of classification of pharmaceutical products in the
marketplace began to be classified in the pharmacy
series and a few people began to be hired for their
pharmacy knowledge and identified as such. In these
instances, however, their grade levels were low because
the Civil Service standard for pharmacists did not highly
reward pharmacists for their knowledge. The functions
of compounding and dispensing required more ma-
nipulative than cerebral skills and were not highly paid.
Most of the people with pharmacy backgrounds were
classified as chemists or food and drug inspectors.

With the incorporation of the Food and Drug Ad-
ministration into the Public Health Service, and the ap-
pointment of Dr. James Goddard as Commissioner in
1966, the Agency saw a substantial influx of young
Commissioned Officer Pharmacists who were assigned
to the Bureau of Medicine in a variety of positions.
Most of these people were ‘‘two year’’ officers; the
majority of them either left the service or transferred
out of the agency following Dr. Goddard’s departure
from the Commissionership. A few remained as Com-
missioned Officers and a few others transferred into the
Civil Service, primarily under the Consumer Safety Of-
ficer classification. Economically for many of the young
officers this was a reasonable move.

Jerome A. Halperin, now Deputy Director of the
Bureau of Drugs, told me that when he joined the
Bureau in 1974, he did an informal head count of Bureau
employees who were trained as pharmacists. At that
time he came up with about 125. Included in that total
were about a dozen Commissioned Officers, and two or
three Civil Service pharmacists, GS-9. The remainder,
and by far the bulk of the pharmacists, were classified
as consumer safety officers and chemists. A few were
classified as pharmacologists and one was a physician.
With the exception of the two or three Civil Service
pharmacists, there were not jobs that were clearly iden-
tified as pharmacy jobs. The Commissioned Officers

5 The above information was abstracted from a personal letter to
G. F. Archambault, December 18, 1981 from Jerome A. Halperin,
Deputy Director, Bureau of Drugs, FDA, PHS, HHS.

MAY, 1982

billet descriptions were quite different. Commissioned
Officers fit into a number of programs in the Bureau
including the Drug Problem Product Reporting System,
the regulations writing group, DESI group, the drug ex-
perience group, and the OTC program.

During the 1970's pharmacists began to come “‘‘out
of the closet’? and, in addition, the total number of
pharmacists increased. FDA brought on more Commis-
sioned Corps pharmacists for the drug labeling, OTC
and drug experience programs, and placed four clinical
pharmacists (all with Pharm.D. degrees) in NDE divi-
sions to review DESI drugs. We were aided consid-
erably in this venture by some outside help, primarily
from Bill Skinner, a pharmacist-attorney and the
American Association of Colleges of Pharmacy who
managed to put enough pressure on the Civil Service
Commission to get the Commission to express a will-
ingness to allow extension of the current pharmacist
standard into higher grade levels by drawing parallels in
the kind of work pharmacists do to other kinds of jobs
done in the Bureau of Drugs. As a result, several of the
Civil Service pharmacists brought on into the labeling
program were classified as GS-12 and the four clinical
pharmacists were classified as GS-13’s.

In the late 1970’s the pharmacists began to organize
and in 1980 formed a Society of FDA Pharmacists. The
Society meets several times per year, usually at noon
for ‘‘Brown Bag Lunch’”’ meetings. The membership list
contains about 150 names including people who are as-
signed to the Bureaus of Drugs, Radiological Health,
Biologics, Medical Devices, Foods, Veterinary
Medicine and the Commissioner’s Office and EDRO.
The broad representation attests to the acceptance of
the Society by pharmacists and their willingness to
stand up and be counted.

The Consumer Safety Officer classification con-
tinues to be the most usual place to find pharmacists;
the chemist classification is close behind. The propor-
tion of Commissioned Officers to Civil Service
employees has continued to increase. Recently, the
Bureau of Drugs has added another half dozen Commis-
sioned pharmacists drawn from the closing of PHS hos-
pitals and clinics. Among the recent pharmacists as-
signed to FDA is Kent Johnson, Pharmacist Director,
Former Chief, Pharmacy Service, USPHS Hospital at
New Orleans, who has been appointed the Deputy Di-
rector of the Division of Generic Drug Monographs, a
position of substantial importance. —to be continued

C. Murray Allen, Past President of the Allegany/
Garrett Pharmaceutical Association, died of a heart

attack in February. He was extremely active in the
Local Association and will be missed by his friends
and colleagues in Pharmacy.

If our new Order Entry System
doesn't save you time and money
within 6O days, you don’t
Owe us a ciime for the system.

¢ Order 50% ¢ Place Orders

Faster In 60-Seconds
¢ Better | ¢ Item and
Stock Shelf Labels
Condition
¢ Complete
¢ Better Pricing and
Pricing Product
Information Information

District Wholesale Drug Corp.
7721 Polk Street
Landover, MD 20785
(301) 322-1100

Loewy Drug Co.
6801 Quad Avenue
Baltimore, MD 21237
(301) 485-8100

Spectro Industries, Inc.
Jenkintown Plaza
Jenkintown, PA. 19046
(215) 885-3676

Divisions of

Thanks,
University of Maryland
School of Pharmacy

Baltimore, Maryland

These young people recently spent a very full day
at Abbott, touching bases in research, development and
production.

Many of them were impressed— and said so— with
the hundreds of steps and precautions taken to assure a
top-quality product.

We were impressed, too— with them.

They were bright, curious, professional and very excited
about their careers.

Cc) It was a good day. And one way we know of starting —
ran and keeping—a dialogue.
2043459

MAY, 1982

"B howe magaynes, feprrcaek books
PE. brah To dee eth

agatn oo Jeeer heaya, 5

That's the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

18 THE MARYLAND PHARMACIST

Medicaid Fraud Unit Prosecutions*

Type of Date of Date of
Name Provider Indictment Prosecution Penalty Judge
1. Kirson Medical Medical 10-15-79 04-10-80 PBJ; 2 yrs. prob.; $4,180.10 H. Grady
Equipment Co. Supplies restit.
2. Donald Kirson Pharmacist 10-15-79 Acquitted H. Grady
3. Jerome Kirson Pharmacist 10-15-79 06-19-80 PBJ; 1 yr. prob. H. Grady.
4. Kirson Drug Co. Pharmacy 10-15-79 06-19-80 PBJ; 3 yrs. prob.; $500 H. Grady
restit.
5. Arthur Levin Pharmacist 08-14-80 10-30-80 PBJ 2 yrs. prob.; $76.16 E. Bothe ;
restit. and 500 hrs. pub.
service.
6. Henry Sugarman Pharmacist 08-12-80 11-12-80 PBJ 2 yrs. prob.; 600 hrs. E. Bothe
pub. service.
7. Leonard Goldberg Pharmacist 08-12-80 11-12-80 PBJ 2 yrs. prob.; 600 hrs. E. Bothe
pub. service.
8. Harvel, Inc., T/A Pharmacy 12-29-80 02-10-81 $2,500 fine. J. Hargrove
Hammonds Lane
Pharmacy
9. Albert Friedman Pharmacist 12-29-80 02-10-81 $1,500 fine; $54.90 restit.; J. Hargrove
2 yrs. prob.; 200 hrs. pub.
service.
10. Marian Butler Pharmacist 12-29-80 02-10-81 $1,000 fine; $61.92 restit.; J. Hargrove
2 yrs. prob.; 150 hrs. pub.
service.
11. The Apothecary Pharmacy 12-29-80 04-27-81 PBJ; 1 yr. prob.; $8.67 P. Dorf

Shoppe of Havre de
Grace, Inc.

PBJ—Probation Before Judgment

restit.

* As of March 1, 1982

FDA Warns about Drugs

Recently there has been an increase in media atten-
tion to issues surrounding the safety and effectiveness
of generic drugs marketed in the United States. A seg-
ment aired last month on a national news television pro-
gram reported on the death of an Ohio woman which
was attributed to the ingestion of unapproved generic
furosemide tablets obtained in the marketplace and sub-
sequently dispensed on prescription.

The large increase in the number of generic drugs on
the market is the result of several factors. Among these
are: 1) expiration of patents on a number of drugs with
large market potential, 2) passage of drug substitution
laws by State legislatures, and 3) challenges to federal
drug laws in a number of legal actions. These and other
factors have encouraged firms to enter the market with
generic counterparts in a rapid manner, in some in-
stances without the approval of the Food and Drug Ad-
ministration even though such approval may have been
required. We have proceeded with a number of regula-
tory actions which have resulted in removal of many
unapproved drugs from the market. In fact, we believe
that no new unapproved generics have entered the mar-
Ketplace during the past year.

MAY, 1982

However, we caution pharmacists that there may
still be unapproved drugs which entered the market
previously that still remain on wholesale and retail
shelves. Such products may posses safety and/or ef-
fectiveness problems and we encourage pharmacists to
examine their stocks. The approval status of marketed
drugs as well as their therapeutic equivalence is detailed
in Approved Prescription Drug Products With
Therapeutic Equivalence Evaluations distributed on
subscription by the U.S. Government Printing Office.
Interested persons may subscribe (at a fee) or call
FDA’s Bureau of Drugs at (301) 443-1016 to obtain the
status of any drug in question.

Should we become aware that unapproved drugs
with significant medical implications are again entering
the market, we will alert you by one of these advisories.

We would appreciate it if you would give this infor-
mation the greatest possible circulation among your
memberships and patrons. We believe it will answer
some questions in the professional community.

Should any questions arise, we will be pleased to
provide whatever information is needed. We can be
contacted at (301) 443-1016.

19

/, Twice-a-year

' expiration dating—
for convenient, accurate
inventory control

JUL 8

100mg

Quality

Control No.
SANDOZ

NDC 0078-0005-05
MELLARIL @ 100 mg
NDC 0078-0005-05
MELLARIL ®
SANDOZ

Exp. Date

Advance notice of price
~ \ and product changes—
includes early notice to third-party
so, Sse payers to assure your proper
ne reimbursement

Sandoz listens...
to serve pharmacy better

SS ge ». one book keeps you up-to-the-minute on
Nee & price listings and complete

= S72 rs information on Sandoz products

ah >
GRMN Ss :.
SS SA VMAGOOHS ELE
[RR AES

<Sp Product reference guide—

Returned-goods policy—
computerized to give you the fastest
possible response

S,

SANDOZ spz 2-140

SANDOZ PHARMACEUTICALS
EAST HANOVER, NJ 07936

© 1982 Sandoz, Inc.

FDA lists new drugs for 1981

The 27 new drug chemicals, and their trade names and indications, approved in 1981:

Generic Name
Albuterol
Alprazolam
Alprostadil

Amiloride hydrochloride
Atenolol

Bethanidine sulfate
Buprenorphine
Captopril

Cefotaxime sodium
Ceruletide

Estramustine phosphate sodium
Flunisolide

Gemfibrozil

Halazepam

Isosulfan Blue
Ketoconazole
Mezlocillin

Moxalactam disodium
Nifedipine

Piperacillin sodium
Saralasin acetate

Secretin

Sucralfate

Sulfadoxine (Pyrimethamine)
Temazepam

Trazodone

Verapamil

Trade Name
Schering’s Proventil
Upjohn’s Xanax
Upjohn’s Prostin VR

Merck’s Midamor

ICI Americas’ Tenormin
A.H. Robins’ Tenathan
Eaton’s Buprenex

Squibb’s Capoten
Hoechst-Roussel’s Claforan
Adria’s Tymtran
Hoffman-LaRoche’s Emcyt
Syntex’s Nasalide
Warner-Lambert’s Lopid
Schering’s Paxipam

Hirsch Industries’ Lymphazurin
Janssen’s Nizoral

Miles’ Mezlin

Lilly’s Moxam

Pfizer's Procardia
Lederle’s Pipracil
Norwich-Eaton’s Sarenin

Kabi Group’s Secretin-Kabi
Marion’s Carafate
Hoffman-LaRoche’s Fansidar
Sandoz’s Restoril

Mead Johnson’s Desyrel

Indication
Bronchodilator
Antianxiety
Palliative therapy to maintain
ductus arteriosus in newborns
Antihypertensive
Antihypertensive
Antihypertensive
Narcotic analgesic
Antihypertensive
Antibiotic
Antiulcer
Antineoplastic
Symptoms of seasonal rhinitis
Lipid regulating agent
Antianxiety agent
Lymphatic contrast agent
Antifungal (internal)
Antibiotic
Antibiotic
for angina
Antibacterial
Detection of angiotension
II-dependent hypertension
Pancreatic diagnostic
Anti-ulcer
Antimalarial
For insomnia
Antidepressant
Supraventricular tachyarrythmias

Joint Commission Members
Support Uniform Policy on
Expiration Dates

for Pharmaceutical Products

Members of the Joint Commission on Pharmacy
Practitioners have supported uniform semiannual expi-
ration dating in January and July for all prescription
drugs. The Commission recognizes the difficulties as-
sociated with uniform January and July dating for prod-
ucts with relatively short shelf lives, but will urge man-
ufacturers to use the January and July dates to the ex-
tent possible, and especially for those with a shelf life of

MAY, 1982

Knoll’s Isoptin and Searle’s Calan

at least 60 months. Members of the Commission have
taken this position to assist pharmacists in inventory
control and assure patients’ medications are dispensed
or returned prior to the expiration dates approved by
the Food and Drug Administration.

The Commission contacted pharmaceutical manufac-
turers during 1981 to determine (1) current expiration
data policies, (2) if the firms would consider adopting
the policy supported by members of the Commission,
and (3) reasons for not adopting this policy. Following
an exchange of correspondence with executives of
the companies, several manufacturers are reviewing
current policies with the expressed hope they will be
able to assist practitioners with this important matter.
Many manufacturers have already adopted the January
and July dating on many of their products.

21

When

was the

last time

your
insurance
agent

gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG —

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville, Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
BERNARD B. LACHMAN EVERY YEAR!
Usually for more than 20% of his premium.

BUNKY is one of the many Maryland pharma-
cists participating in the Mayer and Steinberg/
MPhA Workmen’s Compensation Program—
underwritten by American Druggists’
Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS...
call or write:

Your American Druggists’ Insurance Co. Representative

7 AMERICAN
wy. DRUGGISTS
INSURANCE

Please contact me. | am interested in receiving more

information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. O Call O Write.

Melvin Rubin (left) presents David Banta (right) with the award for
the Honorary President at the Alumni Association Banquet on
March 14, 1982.

The Annual March Dinner meeting of the Alumni Association also
heard Dr. John Toll, President of the University of Maryland bring
greetings.

Alex Mayer, Pharmacist and partner in the firm of Mayer and
Steinberg, has announced his retirement after many years of
serving the insurance needs of the pharmacy community.

MAY, 1982

A featured attraction at the Alumni Banquet was well-known Bal-
timore Disc Jockey, Johnny Walker. Mr. Walker entertained the
audience with his special brand of humor and answered many
questions about the broadcast business.

No Alumni function would be complete without the special innvo-
cations of Samuel Goldstein.

Albert Farmer, Chancellor of the UMAB campus greeted the
Alumni Association banquet. At this affair he informed Associa-
tion officers that the Kelly Memorial Building would not be moved
or destroyed to make way for University expansion.

Pio}

The R&D maze 1S
along and costly
road to travel.

Luck does not bring life-saving products to market....
a well planned Research and Development Program
does. ..but, the R&D maze is a long and costly road to
travel. Recent studies indicate that it takes as much as 10
years and $70 million to bring a new medicine to market.
This year Pfizer will spend over $200,000,000 on R&D in
an effort to provide new products that are safe and effec-
tive and meet our high standards of quality. Pfizer's R&D
commitment today helps to assure better health tomorrow.

PHARMACEUTICALS
Pfizer Laboratories, Roerig, Pfipharmecs

THE MARYLAND PHARMACIST

Se é _ ¢ £3 ae
Wendell T. Hill, Jr. Dean of the Howard University School of
Pharmacy welcomes Pharmacists to the Continuing Education
Coordinating Council’s March 14th program held at the Howard
University Hospital.

Do Not B
Stair Exit

herapy at the Seminar.

Sumner Yaffe presented an overview of Pediatric therapeutics.

This page donated by
District-Paramount
Photo Service.

DISTRICT PHOTO INC

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

MAY, 1982

Wendy Klein-Schwartz Chaired the program for the Council and
served as Moderator.

Avis J. Erickson (left) presented the topic of drug therapy during
Lactation and Gary Cupit (right) discussed treatment of common
disorders during pregnancy.

ar
at
: me) |

lie te@uls

Chris Rodowskas assisted the Council in the planning and the
presentation of the program which was the first jointly sponsored
C.E. presentation between the Council and the Howard University
School of Pharmacy.

Pictures courtesy Abe Bloom — District Photo

"AS UPJOHN
PHARMACISTS, THEIR

GREAT SATISFACTION
_ ISIN HELPING YOU

AND THE PHYSICIAN

MAKE THE RIGHT

DRUG DECISIONS FOR

©1982, The Upjohn Company, Kalamazoo, Michigan

THE MARYLAND PHARMACIST

LST hates)

Dear Dave,
Congratulations to you and the Industrial Relations
Committee.

For 8 months, I tried unsuccessfully to get Winthrop
Labs to honor a return of outdated Rx items. I wrote to
them on a number of occasions, but to no avail. I was
not even afforded the decency of a reply.

I finally turned to our association for help. You and
the Committee presented my complaint to Wintrhop on
Feb 23, 82. Lo and behold! by March 10, I received my

replacement goods. I just couldn’t believe it.

Thanks again for demonstrating the power and use-
fulness of our organization.

Nathan Schwartz

Dear Mr. Banta:
Subject: Marion’s New Prescription Drug Plan

We appreciate the rapid response to my letter of
January 18 and would like to bring you up to date with
our progress in revising the Marion Prescription Drug
Plan. Marion has been busy!

The response we received from pharmacists and
pharmaceutical association executives from all over the
United States has been very helpful to us in setting the
objectives for our plan. Very simply, our objectives are
to pay the usual and customary dispensing fee in the
amount which a pharmacy usually charges its custom-
ers. Simple as that sounds, we discovered that it is not
an easy task for third party administrators to handle.
Therefore, Marion has set up its own plan, using a third
party administrator, Risk Management Council, Inc. of
Arkansas. This plan will be effective April 15, 1982.

The method by which our plan will pay usual and
customary dispensing fees is pretty straightforward: If
one pharmacy determines that its dispensing fee is a
percentage of the average wholesale price of the pre-
scription, Marion will reimburse this amount to that
pharmacy. On the other hand, if another pharmacy
charges an average dispensing fee that is the same for all
prescriptions filled, we will reimburse that pharmacy for
its dispensing fee, because the amount represents its
usual and customary fee.

Other uncommon features of the Marion Prescrip-
tion Drug Plan are likewise oriented to simplicity. Our
plan does not require any type of membership fee or
membership agreement for pharmacies to participate.
Each plastic identification card carried by a Marion as-

MAY, 1982

sociate includes a plan description on the back of the
card, which provides the pharmacist with details of how
the plan works and a toll free number to call for ques-
tions. Marion’s normal procedure will be to reimburse
pharmacies within one week of receipt of the universal
claim form, unless the pharmacy desires a different time
frame.

Marion places a very high priority on its relationship
with pharmacists throughout the country. Because of
this relationship, we want to assure that our prescrip-
tion plan treats each pharmacist fairly. We sincerely
hope that this new Marion Prescription Drug Plan meets
each pharmacist’s needs as a third party reimbursement
prescription drug plan.

We thank you for your help and would appreciate
your passing along information to your members about
the new Marion Prescription Drug Plan. Should you have
any questions concerning this Plan, please feel free to
contact Mr. Gene D. Muhlenpoh, Director of Compen-
sation and Benefits, on our toll free number of (800)
821-3406.

Sincerely yours,
Fred W. Lyons, Jr.

wo » :

ACTUAL SIZE

Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the “P.D.” designa-
tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
Maryland Pharmaceutical Assn.
650 W. Lombard St.
Baltimore, Md. 21201

27

Semel
ee
sen
tes
vee
some
nee
omnes:
nee

1980, —

PARKE-DAVIS
Div of Warner-Lambert Co
Morris Plains, NJ 07950 USA

FOR ONE GOOD IREASON
OR ANOTHER

With Parke-Davis Generics there’s every
reason fo grow in the 80's.

One good reason is our comprehensive line
of generics—a single source for most
generic needs.

Another good reason fo grow with us is your
Parke-Davis Representative. This specially
trained expert knows your individual generic
needs and is ready to show you how fo profit
most from our broad line.

Then consider the unsurpassed quality of

_ Parke-Davis Generics. Our generic products

are equal in quality to our brand name
products. And they're backed by the same
liability protection as well.

There are many more reasons to grow with
Parke-Davis Generics: the Cash Discount
Plan, General Products Purchase
Agreement...they add up to what we feel
is the best generic package in the

industry today.

c 1981 Warner-Lambert Company PD-220-JA-0173-P-4(4-84)

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

BARBITURATE WITHDRAWAL:

Twenty-one barbiturate addicts were treated with
oral phenobarbital in an attempt to withdraw them from
other barbiturates without experiencing symptoms of
withdrawal. Intravenously administered phenobarbital
has been used in the past, but this is inconvenient and
less acceptable to the patient than is oral therapy. This
group of addicts received large oral doses of phenobar-
bital and none developed seizures or other evidence of
barbiturate withdrawal. CLIN PHARM, Vol. 30, #1, p.
71, 1981.

N-ACETYL PROCAINAMIDE:

Procainamide has been found to be acetylated to
produce N-acetyl procainamide, a metabolite with good
antiarrhythmic activity. In addition, it appears that the
lupuslike reactions seen in patients taking procainamide
(Pronestyl) are less likely to occur if the acetylated de-
rivative of the drug is used. Eleven patients who had
previously experienced procainamide-induced lupus
reactions were given N-acetyl procainamide orally.
These patients were able to tolerate the acetylated de-
rivative thus suggesting that the lupus-like reaction is
caused by the aromatic amino group on procainamide
and that acetylating this site prevents initiation of the
adverse reaction. ANN INT MED, Vol. 95, #1, p. 18,
1981.

LEVOTHYROXINE PREPARATIONS:

Two brand name products of levothyroxine, Syn-
throid and Levothroid (formerly Letter) were adminis-
tered to patients on long-term thyroid replacement ther-
apy. Suitable thyroid function tests were performed to
compare the physiological reaction to these formu-
lations. It was found that these two products are not
interchangeable, and that patients stabilized on one
brand should not be given the other without re-
evaluation. J Am Med Assoc, Vol. 247, #2, p. 203,
1982.

HEART FAILURE:

Patients with severe chronic heart failure are often
given hydralazine (Apresoline) to reduce peripheral
pressure and decrease the work required of the myocar-
dial muscle. Patients who have been on the drug for long
periods of time may develop resistance to the drug and
other vasodilators may have to be used to effectively
decrease peripheral resistance. N Engl J Med, Vol. 306,
#2, p. 57, 1982.

RANITIDINE:

Some patients have experienced resistance to the
use of the H-2 antagonist, cimetidine (Tagamet), and
thus face serious consequences. Three such patients

MAY, 1982

were treated successfully with an experimental agent
called ranitidine. The new drug may be most useful in
patients who do not respond to conventional therapy. N
Engl J Med, Vol. 306, #1, p. 20, 1982.

BLOOD TYPES:

An enzyme isolated from green coffee beans may be
useful in helping to prevent shortages of human blood.
The enzyme, alpha galactosidase, is capable of remov-
ing a sugar molecule from the surface of type B cells
thus converting them into type O cells. Type O cells are
very desirable since they may be infused into anyone
without producing hematological incompatibilities.
Further work is being conducted to find an enzyme
which might convert type A cells into type O cells be-
cause approximately 40% of the population have type A
cells which only 10% have type B cells. Interconversion
of blood cell types may help to alleviate the shortage of
human blood. J Am Med A, Vol. 247, #1, p. 12, 1982.

PROPRANOLOL-QUINIDINE INTERACTION:

Propranolol (Inderal) has been used successfully to
prevent the tachycardia associated with quinidine ad-
ministration. Additionally, the beta-adrenergic blocking
agent has controlled supraventricular arrhythmias
which did not respond to quinidine alone. The
antiarrhythmic action of propranolol has been the sub-
ject of much investigation because the l-isomer of the
drug has beta-adrenergic blocking activity while a
quinidine-like action is associated with the d-isomer.
Since the commercial preparation contains a racemic
mixture of the two forms, it was of some interest to find
which action was most involved in correcting arrhyth-
mias. Clinicians have noted that some supraventricular
arrhythmias respond to a combination of propranolol
and quinidine, but not to either drug alone. Experiments
using the isomers of propranolol in combination with
quinidine indicate that the potentiated response noted
when both drugs are used to treat these arrhythmias is
due to the beta-adrenergic blocking activity of the pro-
pranolol rather than to its quinidine-like effect. J Phar-
macol Exp Ther, Vol. 219, #3, p. 651, 1981.

SMOKING:

Previous information indicated that smoking caused
irreversible changes in the bronchial epithelial lining.
Studies conducted in Australia with autopsy specimens
indicate that some regeneration of tissue occurs after
one stops smoking. Structural recovery is evident to
some extent after two years of abstinence. Statistics
indicate that the mortality from lung cancer of former
smokers becomes identical to that of nonsmokers after
the smoker has discontinued the habit for from 10 to 15
years. Br Med J, Vol. 283, #6303, p. 1567, 1981.

29

SUCCESS BREEDS SUCCESS

First there was

SUDAFED

e #1 pharmacist-recommended
cold tablets:

Then came

SUDAFED PLUS

@ The decongestant with antihista-
mine really sells . . . thanks to your
recommendations

And then

SUDAFED COUGH
SYRUP

e@ All the best of Sudafed with dex-

@ More than 401,200,000 tablets
sold last year. . . and growing ata
rate faster than the market*

tromethorphan and guaifenesin has
made this a real buy for customers of
Sudafed... thanks again to
pharmacists’ recommendations

@ 55% was purchased because
pharmacists recommended it

@ 34% of sales are attributable to
physicians’ recommendations:

“a wane Oo Sted
«ae Ce

chr rt AVS

SAS.
QAAVONS

"Othigg Pe

St Othain

The newest
Sudafed profit maker

SUDAFED S.A.

@ The sustained action capsule that
will open your customers’ nasal
and sinus passages for up to 12 full
hours — without drowsiness

@ 120 mg capsules available in
packages of 10s, 40s and 100s

Display the winners...display the
tine family of SUDAFED products to generate
customer loyalty and PROFITS for you

References: |. Open Call Survey, Am Drug Burroughs Wellcome Co.
Sept. 1981. 2. Data on file, Burroughs Research Triangle Park
me Co Wellcome | North Carolina 27709
30

THE MARYLAND PHARMACIST

Classified Ads

Classified ads are a complimentary
service for members.

Pharmacist interested in establishing own business contact.
Tyrone Willoughby. Phone number: 276-7161. Between hours
of 10 am—8 pm.

Pharmacist Looking for part time work. Call: (301) 526-5666.

PHARMACIST: Opportunity to increase income and explore sales
career. Pharmaceutical company selecting Retail and Hospital
Pharmacist as part time sales consultants. Send Resume to P.O. K
Glasgow, Kentucky 42141

The Maryland Pharmaceutical Association radio show is looking
for a few good pharmacists to be interviewed . . . no experience is
needed outside of Knowledge in any area of Pharmacy, any dis-
ease state you are interested in, or in any special interest in the
health field you want to talk about. | want the community to hear
pharmacists talking about health issues. The format is an inter-
view with me on a subject concerning Pharmacy or health issues. |
am an equal opportunity interviewer, | do not discriminate by sex,
race, religion, national origin, or area of employment. Please call
me, Phill Weiner, at 653-1433

| have felt for some time that Pharmacy needs one of its own to aid
in the sale or conversion of existing Pharmacies and in the plan-
ning of new ones. Having been involved in these areas for many
years for myself, | am now available to my colleagues. | would
ultimately like to have a file on those Pharmacists who want to sell
and those who want to buy in order to match one to the other. | am
also particularly interested in helping Pharmacists change their
image from ‘drugstore’ to professional community pharmacy
and in just cleaning up their stores. | can be reached most of the
time at my Pharmacy. Please call me at 653-1433.

CENTENNIAL MARKET

*Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

“Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

*The M.Ph.A. is offering to the public and its members
the USP publication, “About your Medicine.” This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available—‘‘About your
High Blood Pressure Medicine’’—$3.00 each plus $1.00
postage and handling.

*The Pharmacy Art Print ““Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

*Centennial Apothecary Jars with the Association’s
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

MAY, 1982

calendar

May 2—CECC Program-Oncology, Quality Inn,
Towson (8:45 —3:30)

June 6—10—ASHP Annual Meeting, Baltimore

June 18—20—MSHP Annual Seminar, Williamsburg

June 20—24—MPhA CENTENNIAL CELEBRA-
TION CONVENTION—OCEAN CITY RE-
SERVE EARLY—ROOMS ARE LIMITED
LARGE CROWD EXPECTED

Nov 4—7—SAPhA Regional Convention, Baltimore

Oct. 10—14—NARD Convention (Boston)

HOTLINE NUMBERS FOR
IMPAIRED PROFESSIONALS
467-4224
796-8441
685-7878
467-3387

Physicians —
Dentists
Attorneys
Nurses

We at SELBY DRUG COMPANY
attribute our rapid growth and success
to our ability to make changes. These
changes are made rapidly, when and
where they are needed!!

The SELBY DRUG management

team evaluates sources of supply twice
a year.

Maybe it’s time for you to evaluate
your present drug wholesaler.

For information on our Full Line pro-
gram, please call person-to-person collect
to:

Wallace Katz

Senior Vice President

SELBY DRUG COMPANY

633 Dowd Avenue
Elizabeth, NJ 07201
(201) 351-6700

31

| i | i} A } i} A | A} S| SS, | SS | | AS, |. } SE

| CENTENNIAL CELEBRATION

MARYLAND
PHARMACEUTICAL
ASSOCIATION

SUNDAY
June 20

MONDAY
June 21

TUESDAY
June 22

WEDNESDAY
June 23

June 24

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) ee | | a, | >, | a | a, | >} S-, | >} | as} cassass, } asses } coms, |

“400TH ANNUAL MEETING"

SCHEDULE

Registration open at 12:00 Noon (rooms available at 3:00 p.m.)
Tennis, Golf, Swimming & Ice Skating

Special Commemorative Badges—courtesey SK F—Other special gifts
Welcome Cocktail Party

“Effective Communications’’ Harles Cone, Ph.D.—M.Ph.A. takes
Pharmacy’s message to the public—Sponsored by Upjohn
LAMPA—Brunch, meeting and fashion show

Crabfeast and chicken at Berlin Fire Hall

Squaredance

Patriotic multi-media celebration of the Centennial—Lederle
Opening General Session—House of Delegates

LAMPA Board meeting

Cocktail Party—Annual M.Ph.A. Banquet— Awards—
Special Centennial Address, William S. Apple, Ph.D.,
President, American Pharmaceutical Association

House of Delegates—Second Session

Election of Nominees to State Board of Pharmacy
Adoption of Resolutions

Cocktail Party and Presidential reception—Loewy Drug

Centennial Humor—Slide presentation—Morris Cooper,
Curator, B. Olive Cole Museum.

William S. Apple, Ph.D., President of the American
Pharmaceutical Association, grew up, was educated in,
and has spent his working life in the profession of phar-
macy.

Dr. Apple is serving his eighth three-year term as the
elected chief executive officer of the national profes-
sional society, having been elected to the APhA post
first in 1959. He served in the APhA Headquarters as
Assistant Secretary from 1958 to 1959.

He is a past Vice President of the International
Pharmaceutical Federation, a past member of the
Board of Directors of the American Association for
World Health, Inc., and the U.S. Committee for the
World Health Organization. He is past Vice President
and served on the Executive Committee of the National
Health Council. Dr. Apple is a member of the Commit-
tee for National Health Insurance, and an active
member of the New York Academy of Sciences. He
served five years as President of the American Council
@ on Pharmaceutical Education. He also served as secre-
tary, Vice President, and President of the National Drug
Trade Conference.

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Additional copies of this issue of the Maryland Pharmacist were made
possible through the support of the Warner-Lambert Co.

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 SA

JUNE, 1982 VOL. 58 NO. 6

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor
ABRIAN BLOOM, Photographer

CONTENTS Officers and Board of Trustees

1981-82

j : ve V7 Honorary President
2) UEESTESEY Message Philip iT. Cogan JOHN C. KRANTZ, JR., Ph.D. — Gibson Island

President
4 Elder-Health, Partnership in Care PHILIP H. COGAN, P.D. — Laurel

President-Elect
Peter P. Lamy, Ph.D., MILTON SAPPE, P.D. — Baltimore

Madeline Feinberg, Pharmacist Vice-President
IRVIN KAMENTZ, P.D. — Baltimore

22-23 Letters of Endorsement Treasurer
MELVIN RUBIN, P.D. — Baltimore

Executive Director

26 A Brief History of USPHS Pharmacy in Maryland DAVID BANTA, M.A. — Baltimore

= George F. Archambault Executive Director Emeritus
NATHAN GRUZ, P.D. — Baltimore

28 Abstracts TRUSTEES
SAMUEL LICHTER, P.D. —- Chairman
Randallstown
WILLIAM C. HILL, P.D. (1984)
Easton

DEPARTMENTS GEORGE C. VOXAKIS, P.D. (1984)
Baltimore
BARBARA BARRON, P.D. (1983)

2/ Calendar Rising Sun, Maryland
STANTON BROWN, P.D. (1982)

: Silver Spring
31 Classified Ads RONALD SANFORD, P.D. (1982)

Catonsville

DUDLEY DEMAREST, SAPhA (1982)
Baltimore

EX-OFFICIO MEMBER

ADVERTISERS WILLIAM J. KINNARD JR., Ph.D. — Baltimore

HOUSE OF DELEGATES

25 District Paramount Photo 29 Mayer and Steinberg

30 The Drug House 31 Selby Drug Speaker .

16 Eli Lilly and Co. 14. Smith Kline and French MADELINE FEINBERG, P.D. — Kensington
10 Loewy Drug Company 20 Upjohn Vice Speaker

JAMES TERBORG, P.D. — Aberdeen

24 Maryland News Distributing

a MARYLAND BOARD OF PHARMACY
Honorary President
Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN, P.D. — Salisbury
new address with zip code number. Allow four weeks for changeover. APhA member — : ani
please include APhA number. President
BERNARD B. LACHMANN, P.D. — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore
part of their annual membership dues. Entered as second class matter at Baltimore, Mary- ANTHONY G PADUSSIS P.D. — Timonium

land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201.

PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

2 THE MARYLAND PHARMACIST

JUNE, 1982

President's Message

Recently, a group of pharmacists were asked, *‘What do you feel are the
two most important issues for the success of the profession in the future?”’ All
of the pharmacists agreed that number one was economic survival. It’s hard to
disagree. With the advent of third parties dictating fees, our economic indepen-
dence is eroding away. This is an important consideration for all pharmacists,
not just pharmacy owners. Remuneration for employee pharmacists is directly
linked to the profit and loss statement of their employees. At the same time, I
feel the salary for hospital pharmacists is dependent upon the supply and de-
mand for pharmacists in community practice. You can take pride in the MPhA
Third Party Committee which is working very hard on your behalf to develop
innovative solutions to our dilemmas in the area of third party reimbursements.

There was really no agreement about the second most important issue.
One pharmacist stated that leadership at the federal and state level was the next
most important issue. Another said overcoming the apathy of the masses of
pharmacists was critical. A third talked about unity in the profession and a sin-
gle voice for all pharmacists. Another said education of the public to appreciate
the pharmacist was essential. Another went on about using technicians and be-
coming more efficient.

An observer noted that these are all important concerns, but can we not
see the forest for the trees? Where in the scheme of things does patient care fit
as a common goal. All the pharmacists present agreed that patient care was a
given. Nevertheless, how often do we reflect on ourselves, our problems and
our future? How often do we lose sight of our obligation to serve the patient
better? During the centennial year of ‘‘Remembering Where We Have Been—
Deciding Where We Are Going”’ let us pay special attention to how we can best
serve our patients. :

i
I Lgan
Philip H. Cogan,

President

The Centennial Committee

MARYLAND

Elder-Health eevee

by Peter P. Lamy, PhD. F.A.G.S., Project Director
Madeline Feinberg, Pharmacist, Program Coordinator

developed by: University of Maryland School of Pharmacy
William J. Kinnard, Jr., Ph.D., Dean

ELDER-HEALTH

A program in three parts, aimed at health maintenance/recovery for older adults.

Program Part Target Audience
Elder-Ed The Elderly (seniors)
The Caregiver Program Family (direct caregivers), Significant

others, and health care professionals

Provider Interaction All health care providers, whose
cooperation is necessary for health
maintenance/recovery

ELDER-ED

A pharmacy-based drug education program for senior adults
SUPPORTED BY: Warner-Lambert Company
Morris Plains, New Jersey

and

The Maryland Pharmaceutical Association
A Centennial Project 1982

INTRODUCTION

The Centennial Celebration Committee of the Maryland Pharmaceutical Association recommended a series
of projects for our 100th anniversary. One of the projects is the development of a speakers bureau. A number of
accomplishments can result from the speakers bureau. First, it will enable pharmacists to leave their practice
settings and build a following by getting out into their communities. Second, it will benefit various audiences,
who normally do not have an opportunity to learn about medications and drug regimens. Third, it will enhance
the Association’s ability to promote our Centenarian with a special service theme.

The Elder-Ed program, developed by the School of Pharmacy, will be the model for the speakers bureau. This
program has proved successful and has been met with great acceptance all over the state. The June 1982 issue of
the MPhA Journal, thanks to Warner Lambert and Co., contains copies of program outlines that are used for the
Elder Ed program. With very minimal modification, they can be geared to other audiences. Copies of this
Journal as well as materials from the Maryland Poison Control Center, the Student Committee on Drug Abuse
Education (SCODAE) and the U.S. Pharmacopeia will be available at the 1982 MPhA Convention along with
special instructions on public speaking. All of these materials, of course, will be available to any MPhA member
upon request.

We hope that all pharmacists will attempt to participate in the speakers bureau, at least on a trial basis. It will
be a worthwhile and gratifying experience.

Philip H. Cogan, President

4 THE MARYLAND PHARMACIST

ELDER-ED: A CONSUMER DRUG EDUCATION

PROGRAM FOR OLDER ADULTS

The primary goal of the Elder-Ed program is to assure that patients understand and respond to a particular
therapeutic regimen. Additional goals of the program may be stated as follows:
I. General Goals:
—to assure that the consumer is aware and responsive, one who recognizes that the desired outcome of any
health care or specific therapeutic regimen is a shared responsibility between provider(s) and consumer
—to offset some of the undesirable effects of mass media advertising regarding drugs and drug products.
—to recognize (and respond appropriately) to the diminished physical, psychological and economic resources
of the elderly, in context with measures and/or medicinal agents recommended.

II. Specific Goals:

—to assure that elderly individuals are knowledgeable regarding their medication regimen

—to assure that individuals understand that they need to ask questions of their physicians and pharmacists
and what questions need to be asked.

—to present to older adults facts which argue for the value of preventive care.

—to increase the consumer’s awareness of the value of self-medication IF PERFORMED CORRECTLY.

To this end, the Elder-Ed program presents a variety of talks and discussions designed specifically for the
older audience. Topics selected have been those requested by the seniors themselves and are most popular with
this group. The talks reinforce the specific goals stated above while providing general information on medica-
tions commonly used by the elderly.

Health care practices, such as self-medication for example, are discussed throughout each talk. Emphasis is
continued throughout all discussions and talks on the ACTIVE role a health care consumer must pursue and the
negative aspects of the passive role of the recipient of care.

SELECTED TOPICS OF THE ELDER-ED PROGRAM

The Wise Use of Medications. Your Rights and Responsibilities as a Consumer
This is a general talk, centered around the Elder-Ed publication You and Your Medicines. At this, as well as at
all other presentations, the publication Your Personal Medication Record Card, is distributed. Filling it out
can be a service offered at the pharmacy. It is stressed that the Record Card should be carried by the elder and
discussed with every prescriber.

Aging and How it Affects Your Response to Medications
This can be the first in a series of talks which follows the ‘‘drug”’ as it travels through the body. It highlights
what changes occur as we get older, and why drugs may act differently in older persons.

Generic Drugs, Prescription Drug Prices, and Pharmacy Services
Saving money and the cost of medications are of major concern to séniors. The pamphlet Everything You Ever
Wanted to Know About Generic Drugs, can be used along with How to Choose Your Pharmacy/Pharmacist in
presenting this topic. Advantages and disadvantages of using generic medications, cost savings and therapeu-
tic equivalences (bio-inequivalences) are described. Pharmacy services are also discussed with emphasis on
how these services contribute to the health of the patient.

How to Select a Non-Prescription Medication
Guidelines for self-medication are covered with emphasis on the role of the pharmacist in selecting a product
with the consumer. Special attention is given to cough and cold preparations, analgesics, laxatives and
antacids. Pamphlets entitled Medicines Without Prescriptions, Skin Care and You and Your Eyes are available
for distribution.

Nutrition and Vitamins for the Older Adult
Principles of good nutrition are emphasized. Some of the current vitamin and mineral fads are discussed and
caution is advocated for the elderly. The ElderEd pamphlet Vitamins Are Not Enough provides the basis for
this topic.

an essential point

NEVER UNDERESTIMATE THE DRUG KNOWLEDGE OR DISEASE KNOWLEDGE
OF THE ELDERLY!

JUNE, 1982

Format: Outlines of each topic follow and can be used as a guideline for the speaker. Of course, questions or
special audience preference may alter the planned program. Be firm in steering the talk. Set the rules
early and request that personal questions be reserved for discussion after the program.

Hints: —Present the talk in about 20-30 minutes

have too much glare. Posters are hard to read, especially for the
impairment.
—Speak slowly and clearly, as elderly may have hearing impairment.

—Avoid the term ‘‘drug’’—use ‘“‘medication’”’

—Leave plenty of time after program for questions (even after question period). Be ready to ask

questions to break the ice.

SETTING UP AN ELDER-ED TALK IN
THE COMMUNITY

Whom to Contact:
—recreation or program directors of local senior groups
—mention to customers

—post signs at prescription counter that pharmacist is available to speak to senior groups

—place ad in local papers
—Area Agencies on Aging
—senior retirement centers

Assuring a Good Turnout:
—give sufficient notice (one month at least) allows people to make plans
—ask director of program to announce in Center newsletter
—Request that announcement be made one week prior to talk as reminder

Doing your own publicity
—post notice in pharmacy window (large letters, bright colors)
—ask local merchants to post notice
—ask local radio station to make public service announcement

Sites to Contact: Where we’ve been
churches & synagogues
retirement communities
senior citizen housing
public library
local hospitals
social service agencies
Foster Grandparents Program
Senior Companion Program
county commissions on aging
Area Agency on Aging
county and city recreation programs
nursing homes (staff & families)
political groups (e.g. Gray Panthers)
senior organizations (e.g. A.A.R.P.)
eating together sites
senior day care programs

Health Fairs—some guidelines for participation

—give participants their own Personal Medication Record Card

ing, others

—Introduce yourself and the topic. Why was the topic chosen and how will it help the elders?
—Be entertaining! Use anecdotes from your own experience or share a joke if appropriate.
—Slides and posters do not hold attention. Darkening the room distracts from attention and slides may

—Elderly are interested in themselves and in their personal experiences. Select examples of drugs
with which most are familiar, e.g. aspirin, nitroglycerin, hydrochlorothiazide

—insist that pharmacist be responsible for medication screening at registration desk

—be sure medication history is taken prior to hypertension screening, glaucoma screening, diabetes screen-

elderly who may have vision

THE MARYLAND PHARMACIST

—if you identify problem with medication, be certain adequate follow-up service is provided through the
Health Fair Site director.
Suggested Group Size: the audience size can vary
from 5 persons to 500
—get approximate size from director or coordinator so that you have sufficient materials

Where to Get Pamphlets for Distribution: contact
Elder-Ed Program
School of Pharmacy
University of Maryland at Baltimore
20 North Pine Street
Baltimore, Maryland 21201

cs re cr rr cr rr cr cr cr rr crs cr cr crs cere crm rs cs cms crs es es ere ee es ces es es es ee ees es ee ——

YOU AND YOUR MEDICINES: YOUR RIGHTS
AND RESPONSIBILITIES AS A CONSUMER
I. Introduction
1. Introduce self
2. Involve the audience:
—how many people here take at least one medication a day?
—more than one medication?
—how many people take a vitamin every
day?
—how many drink coffee, smoke cigarettes,
drink alcohol?

Il. What is a drug (medication)
1. Define
2. What is the “‘therapeutic”’ effect of a medication (ask the audience to participate)
e.g., aspirin:
relief of pain
reduces fever
reduces inflammation
prolongs clotting time (anti-platelet effects)
(be familiar with latest information especially since elderly have misconceptions about this)
3. What are side effects, or unwanted effects with aspirin (solicit responses from audience)
stomach irritation
bleeding (may be painless)
rash
anticoagulant effect
4. If dose of aspirin is too high, what are toxic symptoms?
ringing in the ears (can elderly ‘‘hear’’ this)

Emphasize: All medications have some side effects associated with their use. When taking a medication,
we want to maximize the benefits of the drug, and minimize the side effects.

Ill. Why are the elderly more at risk for the unwanted (or side effects) of medications?
1. They tend to take more medications (risk of drug interactions is greater)
2. A drug given for one disease may worsen a preexisting disease
3. Elderly may take medications incorrectly
—cannot read the label
—cannot afford medication, so they take it less often
—people living alone tend to make more medication errors
IV. Howcan you, the consumer, get the most benefit from your medications, and expose yourself to the
least risks?
Refer to pamphlet You and Your Medicines:
The educated consumer will be a healthier consumer!
1. The Visit to the doctor:
—what to tell the doctor
—what to bring to the doctor (medications, or Record Card)
—what to ask the doctor

JUNE, 1982 ‘

VI.

VIL.

Personal medication record card—display, explain how to use it.
—list prescription medications
what they are used for
dose
how often
—list non-prescription medications (also products obtained through health food stores)
1. Advantages of keeping your Personal Medication Record Card
—show to ALL doctors (and pharmacists) you may visit
—avoids duplication of medication (e.g. propranolol and Inderal)
—enables monitoring for drug interactions when reviewed by the pharmacist or physician

Choosing a pharmacy . . . Getting the prescription filled
1. How to select a pharmacy. Ask audience what they look for when choosing a pharmacy
2. What you should expect from your pharmacy/pharmacist
—how to take the medication
Ask: What does three times a day mean?
—What does ‘“‘empty stomach’’ mean
—Stress importance of taking medicine with plenty of fluids
—safety vials
—expiration dates
—mixing medications
—sharing medications
—alcohol and medications.

Questions
Old Mother Hubbard... Some were her brother’s
Old Mother Hubbard went to the cupboard some she’d borrowed from others
to get her poor stomach a pill. who had almost the same conditions.
But when she got there, “Tl throw it all out,”
she found bottles to spare, she said with a shout
from other times that she’d been ill. ‘My doctor’s advice I will follow.
There were capsules, and potions, And take only those pills
and drugs for emotions prescribed for my ills,
prescribed by a dozen physicians and use my head before I swallow.”’

THE AGING PROCESS: AND HOW IT CAN
AFFECT YOUR RESPONSE TO MEDICATIONS

Introduction
1. Introduce self and tell about the program
2. Aging: a normal process, not a disease process
a process of change
3. How we change:
—do we still run 3 blocks to catch a bus?
—do we eat like we did when we were 20?
—do we sleep 8 hours a night as we did in our youth?
4. These normal changes may also affect the way medications act in our bodies:
—drugs are tested in young people (under 40)
—elderly may react differently
—pediatrics has become a specialized branch of medicine
—with increase knowledge about the elderly, geriatrics may also become a recognized specialty
5. Why are the elderly at greater risk: THIS WILL BE DISCUSSED AS WE FOLLOW A MEDICA-
TION ON ITS TRIP THROUGH THE BODY.
A trip through the body:
Purpose:
To make you aware of what is happening when you take a medication
To help you avoid some unnecessary side effects

THE MARYLAND PHARMACIST |
)

To help you determine if you may be experiencing side effects and what you should do about it
Ill. Swallowing the tablet:
1. Difficulty in swallowing
—due to dry mouth (normal in older persons, or may be caused by other medications, e.g.
antidepressants, antispasmodics, etc.)
—how to deal with this problem:
crushing tablets (check with pharmacists. Some must not be crushed)
opening capsules (newer capsules may be sealed, check with pharmacist)
2. Dentures—may interfere with chewable tablets and can be irritating
IV. Absorption—tablet goes to stomach where it begins to dissolve so that it can be absorbed into blood
stream
(some medications, e.g., antacids, are not absorbed, but work in stomach: laxatives are not absorbed
but work in small and/or large intestine.)
1. Avoiding stomach upset (one of the major side effects of medication)
—take with plenty of liquids (check with pharmacist which liquids cannot be taken with medica-
tion)
—adequate liquids are IMPORTANT in general. Elderly tend to become dehydrated (often, they do
not feel thirst and forget to drink; or they may avoid fluids)
—discuss what ‘‘take on an empty stomach’? means
—discuss why some medications should be taken with food or milk
—discuss why some products are buffered (e.g., helps aspirin to dissolve more quickly)
—discuss why some products are coated (e.g., Ecotrin®) and how this affects drug action (e.g.
delayed therapeutic effect)

V. Distribution of drug to tissues of body
Once medication is absorbed into blood stream, it is carried to all tissues of body
Factors which determine medication distribution to body tissues:
—Cardiovascular function: may be diminished in older people. Therefore, may take longer for medi-
cation effect
—Changes in body composition with aging: as we age, there is likely to be a decrease in muscle tissue
and an increase in ‘“‘fatty”’ tissue. This can affect how the drug is stored in the body and how well
the medication will work.

VI. Blood Levels: (therapeutic and toxic levels)
In order for a medication to work, you need to have a certain amount of drug present in the body. Think
of a sink:
In order to get the sink half full, you need to add a certain amount of water. If the drain is open, we
need to add enough water to fill the sink as it empties from the drain. On the other hand, if the drain
does not empty well, water builds up and the sink overflows.

Think of the body as a sink. Think of the drug as the water going in. When the drug does not get out
of the body as fast as you put it in, you begin to see more side effects (or toxicities) of the medication.
Other factors may also be involved in how fast the drug is absorbed into the body, then eliminated.
Cardiovascular function, the presence of other diseases, diet and nutrition, exercise and activity levels

and also whether or not you are taking other medications at the same time can affect this process.

VII. Metabolism
The drain of the sink is the liver and kidney, which are the two major body organs that eliminate drugs.
These organs metabolize or eliminate the drug substance.

The liver performs over 5000 chemical reactions. Chemical change usually makes the drug more water
soluble so that it can be eliminated. In some instances, the water soluble metabolite is inactive (will not
have a drug effect in the body), but in other instances, the metabolite will also be active. Then the drug
action may last longer (and you do not have to take as many doses to get the effect of the drug.)

The kidney eliminates many medications from the body in the urine. If kidney function is significantly
slower, this may affect how quickly the drug is eliminated

VIII. Questions you should be asking to determine whether your medication is having the desired effect:
1. Questions to ask the doctor

—How can I expect to feel when I begin taking this medication?

—What is it for, and how long will I have to take it?

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—Can I expect any side effects?
—What special precautions should I take when I use this medicine?
Some common side effects of medications (ask audience to participate)

tiredness diarrhea & incontinence
dizziness blurred vision
constipation mood changes

upset stomach rashes

sleep-changes
2. What should you do if you suspect the drug is not working right?
The pharmacist is the medication expert. He can tell you if the problem is serious and can suggest
solutions.
IX. Conclusion:

The purpose of a drug: it is not to adversely affect a patient’s physical, physiological, mental, nutritional
and health status. Most importantly, drugs should not diminish a patient’s already diminished quality of
life.
REMEMBER: Drug response of the elderly is much more unpredictable than it is in younger persons.
Always expect the unexpected.
Ask questions. Demand answers.

GENERIC DRUGS, PRESCRIPTION DRUG
PRICES AND PHARMACY SERVICES

U Introduction
1. Introduce self
(involve audience, invite participation)

2. What is the most important thing you look for when you choose a pharmacy
—price?
—service?
—convenience?

3. Purpose of talk:
—to discuss prescription drug prices . . . going up (but not as high as other goods and services)
—saving money with generic drugs (can you? should you?)
—pharmacy services—what you are ‘‘buying’’ when you pay for your prescription

PART 1. GENERIC DRUGS

L What is a generic drug? (use pamphlet Everything You Ever Wanted to Know About Generic Drugs)

1. Every drug has more than one name
—chemical name
—generic name
—brand name (give examples)

2. Drug patents: exclusive marketing rights for 17 years
—to defray costs of research and development of drug
—to cover testing of drug before it reaches the market
—to cover advertising costs of product

II. Are generic drugs as good as the brand name? Are they the same?
1. A generic drug can be substituted for the brand name when:
—the drug (i.e. active ingredient) is exactly the same, and
—the medicine has the same effect in the body as the brand name, and
—if it has the F.D.A. approval
2. Sometimes the generic drug looks different from the brand name:
—the color may be different
—the size and/or shape may be different
—it may look the same but have slightly dif-
ferent markings
But, when your pharmacist substitutes the generic product for the brand name, it must satisfy the 3
conditions (above)

JUNE, 1982 I

Ill.

IV.

VI.

VIL.

VII.

If.

What should you do if you get a medicine which is different than your usual medication?
1. Do not take anything which looks different from your usual prescription medication without checking
with the pharmacist:
—most pharmacists will notify you if they have dispensed the generic medication and will point out
the different name on the label
—each state may have different laws regarding generic product substitution. Some states may require
that the pharmacist obtain the doctor’s permission first. Others encourage the pharmacist to
substitute the equivalent drug and to notify the patient. Check with your pharmacist.

How can you get a generic drug?
—ask your doctor to prescribe a generic drug
—ask your pharmacist to dispense the generic drug

How does my pharmacist know if a generic drug is as good as the drug I am already taking.

1. Your pharmacist is the drug expert. He knows what drugs may and may not be substituted

. The pharmacist you trust will only buy his generic drugs from a reputable manufacturer

. Many large, well-known manufacturers now make generic drugs. For example Lederle, Parke-Davis,

Smith, Kline & French manufacture many generic drugs.

4. Most important, the government must approve the generic drug before your pharmacist can pur-
chase it. Many states now use a formulary system which lists only those manufacturers of approved
generics

Ww bo

Why do some doctors refuse to allow their patients to have a generic drug?
—some prefer only the brand name because they have had good experience with it and do not wish to
change

Why do some pharmacies have mostly generic drugs, while other pharmacies have a small selection
of generic drugs?
—many high-volume prescription stores carry mostly generics whenever they can and offer a good
price. In many cases, they may not even carry the brand name in stock
—many smaller pharmacies may not carry a large inventory of generics (which duplicate the brand
name), but instead, may have a larger variety of medicines— especially the less commonly pre-
scribed medicines.
Can you really save 50% with generic drugs?
—as arule, probably not. You can same money. Shop around. Use the telephone. Ask how much it will
cost to have your prescription filled. Be sure you know:
—name of the medication
—strength
—quantity

PART 2. PRESCRIPTION DRUG PRICES

Introduction

We all agree that prescription prices (and those of patent medicines as well) seem to be increasing all the
time. It is true that the manufacturers have been raising prices several times during past years. However,
prescription prices have not risen as fast as most goods and services listed on the Consumer Price Index.

Further, although it may seem that you are paying a lot of money for your medication, we suggest you
figure out how much it costs for each day’s worth of medication.
e.g. 100 tablets @ 20.00 (taking 2 tablets daily) costs 40¢ per day for medication.

How pharmacists price their medications

—cost plus fee

—percent markup

—loss leaders
Loss leaders may be much cheaper for selected popular medicines, but may be more expensive for less
commonly prescribed products.

Other ways to save money

1. It’s cheaper by the 100’s

2. But, always ask for a small quantity when starting a new medicine. It may not be right for you. If you do
well on the medicine, ask the doctor to give you refills in quantities of 100. (This does not apply for all
medications, such as tranquilizers or sleeping preparations.)

3. Ask for senior citizen discount

THE MARYLAND PHARMACIST

PART 3. PHARMACY SERVICES
(refer to phamphlet How to Choose Your Pharmacy/Pharmacist)

I. Special pharmacy services
1. Patient profiles
—some states require by law
—explain what they are, how they are used
—explain how patient should use profiles
shop at one pharmacy
ask pharmacist to list your non-prescription medicines too
ask pharmacist to help you keep your Personal Medication Record Card (available through Elder-
Ed) up-to-date
2. Other (let audience lead discussion)
delivery
how long to fill the prescription
AND REMEMBER ... If your pharmacist does not speak to you, it is your fault. If the pharmacist
refuses to discuss your medications with you, take your business elsewhere!

SELECTING AN OVER-THE-COUNTER

(NON-PRESCRIPTION) MEDICATION
(use pamphlet Medicines Without Prescriptions)

i Introduction

1. Introduce self

2. OTCs—medicines you can buy without a prescription
—are they safe to use?
—do they really work?
—can they interact with prescription medicines?

3. When to consider using an OTC? —~—
—for minor ailments Qy

—for short periods of time

II. Guidelines for selecting a product ”»
1. Diagnosing what is wrong 6 qi)
—experienced symptoms previously?
—minor or severe problem?
—pain or other limiting factors?
—asking friends and neighbors
2. Once we diagnose the problem, do we need a medication?
e.g. treating the common cold:
with medication, it lasts seven days; without médication, it lasts a week. But medi-
cine may make you more comfortable. It may provide some relief of symptoms
3. OTCs are:
—medicines that do work
—medicines that can interact with other medicines
—medicines that can make certain conditions you have worse:
e.g. aspirin and ulcer
antihistamine and prostate
4. Problems with some OTC medications:
—alcohol content
—salt content
—sugar content
—hidden ingredients
5. Using the pharmacist to help in product selection: You should
—know what prescription medications you are taking
—know what other non-prescription medications you are taking
—know your medical history (problems you have had, including allergies)
6. Guidelines for selecting products of 4 major classes of OTCs used by older people.
Analgesics Laxatives
Cough and Cold Preparations Antacids |

JUNE, 1982

14

yt

erDaare lc
gH cob Spreefae
sactasisaliada
AAA lTES

Are you taking advantage of all the
proven methods to promote a phar-
macy's prescription department?

If not, SK&F’s newest 30-minute video-
tape program can start you thinking
about the opportunities you may be
missing.

Our new management program is called
Promoting Your Prescription Depart-
ment—and it’s designed as a seminar
for interested groups of community
pharmacists.

You can learn more about advertising,
promotional budgets, personal selling,
publicity, Oharmacy layout, and evalua-
tion of your promotion efforts.

ARE YOU
“SELLING”
YOUR
PRESCRIPTION
DEPARTMENT?

Promoting Your Prescription Depart-
ment is one more valuable addition to
the pharmacy management series now
available from SK&F.

Ask your SK&F Representative how you
can obtain this videotape program for
your next meeting.

©SmithKline Corporation, 1982

SIKG&F

a SmithKline company

Smith Kline &French Laboratories
Philadelphia, Pa

THE MARYLAND PHARMACIST

JUNE, 1982

B. Acetaminophen
Li

PART 1. OTC ANALGESICS—PAIN RELIEVERS

I. Making a diagnosis: what is causing the pain?
(emphasize) Aches and pains are not a normal accompaniment of aging. Pain is due to injury or disease.
II. Two major choices: aspirin or acetaminophen (Tylenol®)
A. Aspirin (hint: elicit audience participation in discussion)
i

List therapeutic uses:

—relief of pain of headache, joint pain, toothache, etc.
—treduces fever

—reduces inflammation

(also thins blood; may cause sedation for some)

. List common side effects:

—stomach irritation (pain)

—bleeding (may be painless—black stool)
—rash or other allergic reaction

—use particular care with asthma patients

. How to take aspirin correctly: full glass of liquid: list Do’s and Don’ts

When you may have to avoid aspirin:
—gout

—taking an anticoagulant (e.g. Coumadin®)
—history of ulcers

—taking other medications for arthritis
—history of allergies

. Kinds of aspirin available:

—plain (brand name or generic)—most important: FRESH!
—buffered (Bufferin®, Ascriptin®)

—liquid (Alka Seltzer®, watch sodium)

—coated (Ecotrin®)

—with other ingredients (caffeine, antihistamine, other)

. Hidden aspirin:

—in cough and cold preparations
—in many prescription medications (Fiorinal®, Equagesic”)

. Storage: avoid moisture and heat (medicine cabinet)

—stale aspirin (odor, crystal formation) dangerous to take

List therapeutic uses:
—relief of pain
—reduces fever

2. List side effects associated with use:

—none at normal doses (some controversy) LAY
3. When to avoid: a we

—does not interact with most medications ai Pes
4. Kinds of acetaminophen available é

—generic

—liquid form for children and adults

—regular and extra strength

—capsules and tablets

—in combination with other products, both RX and OTC.

PART 2. COUGH AND COLD PREPARATIONS
I. Making a diagnosis—the common cold

—caused by a virus (no cure)
—runny nose or stuffiness
—sore throat

—cough (dry or productive)

15

can be frozen in the Se ae i Sal process, leaving an average
of only nine and a half years to recover development costs.

Surprising? Yes. But the real surprise is that today’s drugs consume only 8 percent of all
health care costs as compared with 16 percent 40 years ago.

Lilly ‘Eli Lily and Company
‘ Indianapolis, Indiana 46285

i 200289

Il.

—fever (slight)
—aches and pains

. What you can do without taking medications:

—rest

—fluid (hydration important: mention chicken soup)
—eating well

—vaporizer

—gargle

. If your cold is serious and requires medical attention

—fever over 101°F

—pain (moderate to severe)

—can’t breathe or catch breath

—mucus which is thick, greenish or bloody
—rash

—symptoms which last more than one week

. Choosing a product to provide relief of symptoms:

No product provides complete relief

Avoid combination products (more costly and may not need all ingredients for your symptoms)
. What to take for aches and pains:

aspirin or acetaminophen

. What to take for sore throat:

—gargle
—hot tea
—hard candy

—lozenges (benzocaine—avoid if allergy; watch sugar content)
. What to take for runny nose and congestion:
—Decongestants (topical: nasal spray; systemic: tablets or syrups)

But avoid if:

—you take medication for high blood pressure
(it causes heart palpitations)

—thyroid problems

—diabetes

May cause:

—overstimulation

—paradoxical drowsiness

—dependence, if using nasal preparation. Follow directions.
Do not use nasal sprays (or drops) and oral decongestants at the same time

—Antihistamines (tablets or liquids)
Avoid if:
—prostate problems
—certain types of glaucoma
May cause:
—drowsiness
—may interfere with vision
—interact with prescription medicine you are taking

. What to take for cough:
—expectorant, brings up mucus, need to drink plenty of fluids for it to work properly
—dextromethorphan (‘‘D.M.’’) cough suppressant for dry, hacking cough

—codeine, a narcotic, may require a prescription

PART 3. LAXATIVES

Making the diagnosis—What is constipation?
Laxatives are one of the most abused medications.

Prevention is the best medicine

1

Diet
—roughage
—fluids

2. Activity

—moving about, getting out of bed or chair

3. Do not postpone or delay when urge occurs

Causes of constipation
—many diseases
—many medications
—diet or lack of adequate fluid intake
—change of environment
—stress
. Choosing a laxative:
—try the mildest first
—‘‘natural’’ may be strong and cause cramping
—needs to be taken correctly to work,
e.g. Bulk laxatives must be taken in plenty of water
Stool softeners are mainly used to prevent constipation
Do not crush laxative pills
. And watch out:
—some laxatives are high in sugar
—some are high in salt
—some may interfere with absorption of nutrients
—many are habit-forming
—some interact with medications

PART 4. ANTACIDS

Diagnosing hyper-acidity: due to

—ulcer

—indigestion

—heartburn

—sour stomach
Diagnosing what causes the pain may save your life! The pain in your chest could be due to heart. Be sure
before treating with antacid.

If you take an antacid and do not get relief, need to check with your doctor
1. Types of antacids available:
—liquids (best)
—tablets (chewable)
—with anti-gas ingredient simethicone
—low in salt and sugar
—high neutralizers
—some are constipating (may be used for diarrhea, e.g. Pepto Bismol®)
—some cause loose stools (may be taken for constipation, e.g. milk of magnesia)
2. Caution!
Antacids interact with most medications, and should be taken at least one hour apart from any other
medication unless suggested otherwise.
MAKING THE RIGHT CHOICE: With all the possible choices, the pharmacist is readily available to
suggest a product to you. You are paying for this service, use it!

NUTRITION, VITAMINS AND MINERALS FOR
THE OLDER ADULT

Introduction
. Introduce self
(Hint: involve audience in discussion)

. How many people here take a vitamin every day?

. What made you decide to take a vitamin (and/ or mineral)?
—doctor
—friend
—magazine article
—advertisement

. Where do you purchase your vitamins?

18 THE MARYLAND PHARMACIST

Vitamins are not a substitute for good nutrition
(refer to pamphlet Vitamins are Not Enough)
1. Discuss components of good nutrition
—what should be eaten daily for health maintenance
2. Vitamins cannot keep you young, and are not pep pills; if used too much they can be dangerous.

III. Vitamins: food supplements or drugs?

1. Two points of view:
—-vitamins are dietary supplements not subject to strict controls imposed on drugs
—vitamins are viewed as drugs and should only be used to prevent a deficiency state or to treat a

deficiency state.

2. Why the controversy:
—our knowledge on the subject of human nutrition is still limited
—most health-care providers do not study nutrition in school

IV. Vitamins:
1. Definition—organic chemical substances (contains carbon). Only very small amounts are required
for health maintenance
2. Two major classes of vitamins:
—water soluble: need to replace daily
includes all B vitamins
Vitamin C
—fat soluble: can store in fatty tissue of body
Vitamin A
Vitamin D
Vitamin E
Vitamin K
3. Define R.D.A. (none established for seniors)
4. Megavitamins—extremely high doses, often used to prevent or cure diseases
Do they? No! Many theories in popular literature, but no good scientific studies to prove this as yet

V. Some thoughts on popular vitamins
1. Vitamin C
—when to avoid
gout
history of kidney stones
if testing urine for sugar (if diabetic)
—can it help the common cold? (Know the latest information)
—know difference between ascorbic acid and sodium ascorbate
—explain how time-release Vitamin C works
—explain difference between ‘‘natural’’ with bioflavanoids and rose hips versus synthetic Vitamin C
—discuss differences in price and true value
2. Vitamin A
—currently most popular as anti-cancer vitamin. Eating cooked yellow vegetables seems to provide
some protection in smokers against lung cancer
—but, only theories; never proven
—different forms of Vitamin A may make a difference in response of individual
—but watch out for toxicities in high doses:
headache
cracked lips
excessive calcium deposits
skin and cornea may turn yellow
nausea and vomiting
3. Vitamin D
—prescribed by physicians for certain bone diseases e.g. rheumatoid arthritis, Paget’s disease, with
calcium for osteoporosis
—elderly home-bound may have true Vitamin D deficiency
—too much Vitamin D may cause
calcium deposits in joints, arteries and kidneys, may increase in blood pressure

JUNE, 1982 19

Do
you know a

pharmacist who
has won this Upjohn

Achievement Award?

Each year it is awarded to the out-
standing seniors in colleges of phar-
macy throughout the country.

Selection of the recipients is
made by the college faculties based
on community service or scholas-
tic achievement. We provide the
plaques and a stipend.

In the 10 years of this program
some 700 pharmacy seniors have
received this award. As pharma-
cists, ourselves, we appreciate what
these seniors have accomplished.
We feel they should be honored and
further motivated.

It is exciting to consider ‘the
contributions these fine
young pharmacists will
make to society
in the years
ahead.

©1982, The Upjohn Company, Kalamazoo, Michigan

4. Vitamin E
—current fads (be prepared to discuss)

—avoid daily amounts in excess of 400 I.U. since large excess may cause
flu-like symptoms
mental confusion
disorders of fat metabolism
5. Vitamin K
—elderly persons, particularly those who take anti-coagulant medications, should be aware of Vi-
tamin K content of foods, particularly tea
6. Vitamin B,»
—usually only used on prescription for pernicious anemia and given mostly by injection
7. B Complex Vitamins
—consists of several vitamins
—lack of B vitamins is responsible for mental confusion (pseudosenility) and change in mood
—believed that Vitamin B complex is needed to resist stress more successfully
8. Other vitamins
—caution the elderly consumer, that from time to time, ‘““new’’ vitamins are introduced (Vitamin B,;,
for example). None have been shown to be effective; many are not vitamins.
VI. The minerals:
1. Definition—These are essential substances needed for health maintenance. They are inorganic sub-
stances. Some are required in comparatively large amounts (macro-elements); others in
very small amounts (trace elements).

—macro-elements include —trace elements include
calcium chromium
chloride copper
phosphorus fluoride
potassium iron
sodium selenium
zinc

2. A balanced diet will provide all essential minerals and trace elements in sufficient amounts.

VII. Some thoughts on minerals and trace elements
1. Iron
—iron is not a pep pill; it cannot “‘give you more energy.”’
—indications for iron therapy
deficiency caused by loss of blood
diagnosed iron-deficient anemia OP
—problems with taking iron
constipating
may cause diarrhea
irritating to stomach and may aggrevate pre-existing ulcer
waste of money if not needed
2. Calcium
—indications for supplementation
treatment (and possible prevention) of osteoporosis
—is calcium alone enough? May need Vitamin D and fluoride supplementation as well
3. Potassium
—discuss potassium-deficiency induced by diuretic therapy
can only be detected by blood test
compare food sources of potassium to prescribed potassium supplementation
—discuss what can happen when potassium is taken without medical supervision. Before deciding
that potassium supplementation is needed, talk with pharmacist.

From 11th century Chinese and Muslim sources:

EXPERTS IN THE USE OF MEDICINES ARE

INFERIOR TO THOSE WHO RECOMMEND A PROPER DIET.
E;

JUNE, 1982 21

UNIVERSITY OF MARYLAND
SCHOOL OF MEDICINE

OFFICE OF THE DEAN 655 W. Baltimore Street
Medical Service Plan Baltimore, Maryland 21201

(301) 528-3481

April 22, 1982

David Banta

Executive Director

Maryland Pharmeceutical Association
650 West Lombard Street

Baltimore, MD 21201

Dear Mr. Banta,

In my capacity as Vice Chancellor for Health Affairs of
the University of Maryland at Baltimore campus and Dean of
the School of Medicine and as Chairman of the Task Force on
Aging, I strongly support the Elder Ed Program sponsored by
the School of Pharmacy. The special needs of the aging have
been recognized and the UMAB campus has responded with an
interprofessional thrust addressing the needs and care of that
particular population segment.

For pharmacy practioners statewide, the Elder Ed Program
has become a resource to answer the demand for information in-
curred by the gathering momentum of the consumer movement. I
commend the project staff for providing this program to the
professionals and the community.

ohn M. Dennis, M.D.
ice Chancellor for Health Affairs
Dean, School of Medicine

22

Dody and th

Citizens 5

at of
more

f Mary lang,

e ey

center on aging

DIVISION OF HUMAN AND COMMUNITY RESOURCES
UNIVERSITY OF MARYLAND

COLLEGE PARK, MARYLAND 20742 (301/454-5856
April 26, 1982

Mr. David Banta

Executive Director

Maryland Pharmaceutical Association
650 W. Lombard Street

Baltimore, Maryland 21201

Dear Mr. Banta:

It is my pleasure to write in recommendation of Dr. Peter
Lamy, Professor of Pharmacy at the University of Maryland at
Baltimore, and his program of pharmacy education for older
people.

Dr. Lamy has made this program, popularly known as "Elder-
Ed,"' a national model for disseminating information on drug-drug

and drug-food interactions with aging. We at the Center on Aging
are proud of his program which, for the past three years, has
been part of a comprehensive gerontology education grant receiv-
ing support from the Administration on Aging, U.S. Department of
Health and Human Services. Dr. Lamy's personal efforts, his
publications, training sessions, and outreach programs are without
question of tremendous benefit to older Americans.

This year the Regional Program Director in Philadelphia
of the Administration on Aging has requested copies of Dr. Lamy's
Elder-Ed publications and has cited this program as an outstanding
example of community-oriented, applied gerontology education.
The Washington Post has written about this program. Elder-Ed
has received deserved attention in Maryland, the Eastern Region,
and the country. I would be pleased to add further details on
Dr. Lamy's accomplishments in this regard.

With best wishes, I remain
Sincerely,
Edward F. Ansello, Ph.D.
Acting Director

THE MARYLAND PHARMACIST

Dear Mr. Banta:

Thank you, on behalf of the Alumni Association of the School of Pharmacy,

for the invitation to contribute to the issue of fhe Maryland Pharmacyst
devoted to Elder-Ed.

We at the Alumni Association are proud to be counted as supporters of this
unique program. It is, we believe, of great benefit to our students, has

been beneficial to the developing curriculum of the School of Pharmacy,and has
Provided an interesting area of contribution to our retired Bharmacists.

But most of all, it meets the standards of what we believe the new Pharmacy

is all about: Service to our patients, service to the citizens of Maryland.

Sincerely

Gee C Urtobus

Ancero ©. Voxnnis
Rg esipew7

Acymur Assocaation
¥e oe Pi ARM AY
UN'S oF MD

-etters of Endorsement

MATTHEW TAYBACK 8C.0 UNIVERSITY OF MARY LAND
SINRE TOR SCHOOL OF PHARMACY

HARRY F WALKER
DeruTy oimectom

STATE OF MARYLAND
OFFICE ON AGING

301 WEST PRESTON STREET
BALTIMORE MARYLAND 21201

TELEPHONE: 30)-383-5064 JAMES F CHMELIK

HARRY HUGHES AssieTanT oimecTOR April 22,1982

GoveRNon

April 21, 1982 David Banta

Executive Director

Maryland Pharmaceutical Association
Mr. David Banta

Executive Director
Maryland Pharmaceutical

:

|

Dear Mr. Banta:
Association

The Klder-Ed program at the University of Maryland School of Pharmacy
plays an important role in the education of pharmacy students. This
program trains students in effective patient communication and in the
awareness of situations dealing with the elderly population. Elder-Ed
provides contributions nad services to the community and toward the
goal of providing patient education.

650 West Lombard Street
Baltimore, Maryland 21201

Dear Mr. Banta:

The Elder-Ed program of the University of Maryland is
an example of the outstanding role which the School of Pharmacy
has played in the development of new pharmacologic knowledge and
in the advancement of pharmacy practice as it relates to the
growing number of senior citizens.

Students members are enthusiastic with their participation in the program.
Many perform additional research in preparation for the talks. The students
believe this is an important part of their education, and want to extend
their resources in developing the program in other schools. This is now’
in process in New Jersey.

A major component of cost of medical care for older
Americans is associated with drug usage and at the same time
such drug use is recognized as a fundamental reason for ex-
tended life and reduction of disability. Elder-Ed is a
unique program to promote efficient use of drugs while
obtaining maximum benefits for the state's senior citizens.

As a member of the program, I find that talking to the elderly
rewarding experience. I have done additional preparations for
and continue to lecture beyond the requirements of the program.

This program is essential. The contributions to the community
to the students are overwhelming. I express an invitation to all

JUNE, 1982

We look forward to continuing significant contributions
of Elder-Ed and personally, I congratulate Dr Peter Lamy, his
staff, the pharmacy students, and retired pharmacists who have
made this program an outstanding success.

fj
Singfrely yours, }

/
win NazbpeR-
fatthew Taybdck, Sc. D.
State Director on Aging

pharmacists that they participate in patient communication, especially
in the means of educating the community, primarily the elderly.

The experience will be rewarding and the development of pharmacist-
patient relations complete.

Sincerely, =

Cd Gres
Aoylpes Us V2 7
Angelique R. Kariotis

President
Student Government Alliance

23

Bus howe magagines faprtaek books

ancl tonics dud Come back le dee etd.

AA A

That's the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

24 THE MARYLAND PHARMACIST

President Phil Cogan (left) and President-elect Milton Sappe
(right) enjoy tearing up the mandatory price posters on the steps
of the Kelly Building. The passage of Association sponsored
HB1170 allows Maryland Pharmacists to take down their price
posters on July 1, 1982.

~

lan Turner of the I.C. Systems has been honored by his com-
pany for ranking third nationally in collection returns for mem-
bers in 1981. 1.C. systems is the Association’s endorsed collection
agency. Turner works out of Mount Airy, Maryland. Contact the
M.Ph.A. for information on their program.

This page donated by
District-Paramount
Photo Service.

DISTRICT PHOTO ING

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
in Baltimore, 792-7740

JUNE, 1982

Dr. Peter Lamy, head of the University of Maryland School of
Pharmacy’s Elder Ed program discusses medications with mem-
bers of a B’nai Brith Women’s group in Baltimore following a pre-
sentation on proper drug use. The Elder Ed program was recently
the recipient of a major grant from the Warner-Lambert Company
to continue its work which is gaining national recognition. In ad-
dition, the Association has adopted the Elder-Ed program as a
model for its Centennial Speaker's Bureau. (See article on page 4).

Bob Green was also congratulated by I.C. systems for ten years
as a District Manager. Headquartered in Joppatown, Green has
added 2200 clients to the program in Maryland. |.C. system has
collected $52 million last year for members of 1000 state associa-
tions nationwide.

Pictures courtesy Abe Bloom — District Photo

A Brief History of USPHS
Pharmacy in Maryland

George F. Archambault

Continued from the May Issue

PART V

Commissioned Pharmacy Officers—Indian Health
Service, USPHS

The first U.S.P.H.S. pharmacist officer assigned to
the Indian Health Service was Allen J. Brands in 1954.
Over the years, the utilization of commissioned and
civil service pharmacists in the Indian Health Service
has grown with the advancement of clinical and institu-
tional pharmacy until today (1982) the compliment is
301. Currently the acting chief of this service is Mr.
Charles V. Erdeljon, a former official of the PHS’s
Emergency Health Preparedness Division and a former
VA Chief pharmacist.

Other than Mr. Erdeljon’s involvement as head of
this segment of pharmacy in the Public Health service
with offices in Rockville, MD (PHS and Indian Health
Service headquarters), this activity does not impinge on
PHS pharmacy in Maryland and is mentioned here only
to indicate that this service is indeed a large user of
pharmacists though mainly in the Western states. These
301 pharmacists service a total of 112 Indian facilities.
(Hospitals and clinics.)

Unfortunately, we do not have available to us at this
time the names of the Maryland pharmacists attached to
this service.

PART VI
USPHS Pharmacists in the U.S. Coast Guard

Here again because the commissioned pharmacists
of the USPHS service do not serve Maryland bases, we
report their presence only to indicate the PHS commis-
sioned officer pharmacists role nationally. Currently
there are six officers attached to the Coast Guard.
Pharm. Dir. Samuel Ingraham of Bethesda, MD in-
volved at Headquarters, (Wash. D.C.) in Health per-
sonnel manpower assignments. Other pharmacist offi-
cers currently on duty with the Coast Guard are phar-
macist Director Vince Fierro, Chief Pharmacist, Coast
Guard; Robert Branagan, Cape May, N.J., Thomas
Dolan, Governor’s Island, N.J., Charles Veach, Coast
Guard Academy, Groton, Conn. and Phillip Lawrence
at the Alameda, California Coast Guard Station.

26

PART VII
National Library of Medicine—Bethesda, MD

The National Library of Medicine at Bethesda,
Maryland is well known to hospital, research, and
academic pharmacists as well as physicians, nurses and
others seeking biomedical information. Its Medline
world-famous information service operates on NLM’s
Computer system. A commissioned pharmacist officer,
highly trained in this medical library research work has
been assigned to the Library since the late sixties—
William H. Caldwell. NLM’s most important publica-
tion is its Index Medicus, published since 1879. Some
20,000 plus bibliography references from journal articles
are added monthly. An excellent article on the N.L.M.,
its scope and goals written by William H. Caldwell, a
graduate of the Univ. of New Mexico College of Phar-
macy and Henry M. Kissman, M.D. appears in Hospital
Pharmacy Management Journal Vol. 8 No. 4, April

19733
PART VIII

PHS Commissioned Pharmacy Officers Assigned
to Fort Dietrich, Maryland

The following officers were assigned to this base
during the years indicated. They served at this duty
station as the Liaison officer to the Office of the Surgeon
GeneralUr >. batiaog

1. Pharm. Dir. (equivalent to Navy Capt.) Boris

Oshenoff. 1960— 1963
2. Pharm. Dir. (equivalent to Navy Capt.) Kenneth
Hanson. 1963-1966

PART IX

Bureau of Prisons—Public Health
Service—Commissioned Pharmacist Officers

Pharm. Director Richard Bertin of the Office of the
Ass’t. Sec. for Health of HHS informs us that currently
there are 8 commissioned pharmacy officers serving in
the Bureau of Prisons. They are stationed at Terminal
Is. Cal., Lompoc, Ca., Lexington, Ky., Fort Worth,
Texas, La Tuna, Texas, Atlanta, Ga. and Lewisburg, Pa.

Of the eight, none are graduates of the Univ. of
Maryland College of Pharmacy or are residents of
Maryland.

THE MARYLAND PHARMACIST

GEORGE F. ARCHAMBAULT, J. D., Sc.D., received the first annual
President’s Award of the American Society for Pharmacy Law. The
award, sponsored by Merrell Dow Pharmaceuticals Inc., is pre-
sented to an individual who has made a significant contribution to
the legal system in relation to the practice of pharmacy.

PART X
P.H.S. Headquarters

The headquarters of HHS-PHS is located in
Rockville, MD on Fishers Lane. Over the years, the
headquarters office has utilized the services of the
Pharmacy Category of Commissioned Officers along
with the other health disciplines, medicine, nursing, vet.
med., sanitation officer, engineers, and others.

The pharmacists currently on duty at this station and
who reside in Maryland are Pharm. Dir. Richard Bertin,
Senior Pharm. William M. Peterson, Jr. and Senior
Pharm. Richard Taffet, all assigned to the Office of the
Ass’t. Sec. for Health.

PART XI
Chief Ranking Pharmacist Officers—USPHSC

The three chief ranking pharmacist officers of the
Commissioned Corps, each with responsibility for over
all pharmacy activities in the service and reporting di-
rectly to the Surgeon General are or were Maryland
residents.

George F. Archambault, Bethesda, MD 1950-1967
Allen J. Brands, Bethesda, MD 1967-1981
Richard Ashbaugh, Rockville, MD 1981 —

Ass’t. Surgeon General Rank for

Pharmacist Officers

;
:

To date four pharmacists have attained the rank

JUNE, 1982

of Ass’t. Surgeon General. In order of appointment
these are:

Edward Duncan—Duquesne University

Allen Brands—University of Southern California
*(Chief, Pharmacist Officer—Retired)

Jerome Halperin—Rutger’s University

Richard Ashbaugh—Temple University (Chief,
Pharmacist Officer)

All are or were Maryland based at the time of their

assignments.
PART XII

The Inactive Reserve

Over a hundred pharmacists were commissioned in
the Reserve Corps in the war years. Well known names
that come readily to mind are:

R. W. St. Clair—Massachusetts College of Phar-
macy (Faculty)

Donald Francke (deceased)—University of Mich-
igan

Wm. M. Heller—U.S.P. Official

Joseph Valentino—U.S.P. Official

George P. Hager—Retired Dean, School of Phar-
macy, University of North Carolina

Robert P. Fischalis (deceased)—Executive Director
(Retired), American Pharmaceutical Association

PART XIII
Conclusion

A reading of this short history of PHS pharmacy and
pharmacists in and of Maryland is by its very nature an
incomplete one. Apologies are made for names inad-
vertently ommitted and duty stations not remembered.
Readers are invited to add to this report by letters to the
editor of this Journal for publication in later issues to
help complete ‘“‘the record.”’

* Promoted to Assistant Surgeon General rank by virtue of new
legislation introduced by Congressman Mickey Leland (D. Texas)
establishing by law the grade of the Chief Pharmacist Officer of the
service.

calendar

June 6—10—ASHP Annual Meeting, Baltimore

June 18—20—MSHP Annual Seminar, Williamburg

June 20—24—MPhA CENTENNIAL CELEBRA-
TION CONVENTION-OCEAN CITY

Nov 4—7—SAPhA Regional Convention, Baltimore

Oct 10—14—NARD Convention, Boston

Every Sunday Morning at 6:30 a.m. on WCAO-AM and 8:00 a.m. on
WXYZ-FM, listen to Phil Weiner broadcast the Pharmacy Public
Relations Program ‘Your Best Neighbor,” the oldest continuous
public service show in Baltimore.

27

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

CHILDHOOD ALLERGIES:

Certain types of allergies seem to subside as one
ages and children who experienced bronchiolar asth-
matic attacks may suffer less as they age. Two types
of allergens, house dust and rye grass, were studied in
children for a five-year period of time. These two al-
lergens were selected for study because house dust is a
perennial allergen while rye grass is classified as an in-
termittent seasonal allergen. Results indicate that if the
child is in constant contact with the allergen, e.g., the
perennial allergen such as house dust, symptoms tend to
decrease with age. However, in the case of seasonal
allergens, symptoms may remain into adolescence and
adulthood. Lancet, Vol. Il, #8260, p. 1359, 1981.

DIABETES MELLITUS:

Insulin-dependent diabetes mellitus is a condition
thought to be due to inherited susceptibility and envi-
ronmental factors. Studies indicate that the onset of
beta-cell destruction even in children may preceed the
development of clinical symptoms by as much as sev-
eral years. Studies are being conducted to determine if it
might be feasible to detect patients in their prediabetic
state with the goal of searching for ways to prevent the
beta-cell deterioration and/or using patient education to
help minimize and control their condition. Lancet, Vol.
II, #8260, p. 1363, 1981.

PEPTIC ULCERS:

Bleeding peptic ulcers can lead to death and rapid
intervention is often necessary in order to prevent seri-
ous consequences. Ulcer patients in England were di-
vided into two groups, and one group was subjected to
photocoagulation therapy with an argon laser while the
other group served as control. Results were encourag-
ing in the laser-treated group and these authors suggest
that this procedure be considered for use more fre-
quently when serious bleeding ulcers are encountered.
Lancet, Vol. I, #8259, p. 1313, 1981.

KETAMINE:

Ketamine is an analog of PCP which has found par-
ticular usefulness as a general anesthetic in children. In
addition to its action on the central nervous system,
ketamine also causes relaxation of skeletal muscles. A
study of ion flow at the skeletal muscle receptor site
indicates that the prolonged action potential associated
with the ketamine-induced muscle relaxation is due to a
blockade of sodium channel inactivation rather than to a
delay in potassium conduction. Investigators have
speculated that this interference with ion flow may also
be responsible for some of the weak hallucinatory reac-
tions noted in some people who receive ketamine. J
Pharmacol Exp Ther, Vol. 219, #3, p. 638, 1981.

28

PARATHYROID HORMONE:

Uremic patients suffer from bleeding tendencies, but
thus far no explanation has been presented to elucidate
this finding. Platelet aggregation is affected by various
endogenous materials. Aggregation becomes more
likely in the presence of thrombin, collagen, ADP,
serotonin, catecholamines and thromboxane A-2 while
the opposite effect is seen when adenosine, prostaglan-
din D-2 and/or prostacyclin is present. Since there
seemed to be no abnormalities in the concentration of
any of these substances in the uremic patient, another
agent must be causing the problem. Investigators now
feel that parathyroid hormone is a major uremic toxin
and is the agent responsible for producing bleeding ten-
dencies in uremic patients. Lancet, Vol. Il, #8259, p.
1321198 Ie

ALPHA ADRENERGIC AGENTS:

Several new drugs have been found to act on the
alpha adrenergic receptor site. Cirazoline is a drug
which acts specifically on the alpha-1 site in a manner
similar to that exerted by phenylephrine (Neosyneph-
rine). Prazocin (Minipress) blocks this site selectively.
Agents which stimulate alpha-2 receptor sites include
clonidine (Catapres), tramazoline and azepexole. These
drugs are being used experimentally to study the loca-
tion of specific subtypes of alpha receptors. J Phar-
macol Exp Ther, Vol. 219, #3, p. 760, 1981.

TERBUTALINE:

High density lipoproteins are considered beneficial
lipoproteins and elevated levels are associated with a
reduction in the risk of coronary artery disease. These
substances apparently remove cholesterol from the cell
and take it to the liver for excretion. Patients receiving
terbutaline (Brethine) were found to experience an in-
crease in the concentration of high density lipoproteins
thus suggesting that this anti-asthmatic agent may have
some use in controlling cholesterol levels in the tissues.
N Engl J Med, Vol. 305, #24, p 1455, 1981.

ESSENTIAL HYPERTENSION:

Blood pressure increases with age and in proportion
to the sodium content of the plasma. In a study of 42
patients, data accumulated suggest that the elevation of
sodium in the serum of hypertensive patients may be
due in part to the increase in the concentration of an
inhibitor of sodium transport which accumulates in pa-
tients with the condition. Efforts are being made to
identify this transport inhibitor and see if it might be
removed in order to help reduce blood pressure. Br Med
J, Vol. 283, #6303, p. 1355, 1981.

THE MARYLAND PHARMACIST

When

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last time
INSULANCE wevegeessnswwce,

RONALD A. LUBMAN EVERY YEAR! Usually ~

agent _ for more than 20% of his premium.

RONNY is one of the many Maryland phar-
macists participating in the Mayer and

ave ; Ou | Steinberg/MPhA Workmen’s Compensation
_ Program—underwritten by American

Druggists’ Insurance Company.

a check For more information about RECEIVING
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call or write:

th at you Your American Druggists’ Insurance Co. Representative

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30 THE MARYLAND PHARMACIST

AD NO. 104-A

Classified Ads

Classified ads are a complimentary
service for members.

Ocean City Condos for rent, sleeps six, pool, AC, TV, Fully
Equip, Great Rates contact Don Strand 465-7295 evening.

Registered Pharmacist—desires full time position in local
pharmacy. Contact collect: John J. Selak 717-352-2619.

Space Available Old Mill Plaza Shopping Center Rt 3 Old
Mill Road, Anne Arundel County, Millerville Md. 21108.
1300 to 6500 feet very attractive terms, short or long
term lease. For information call Rus Poole at Baltimore
area 265-5500.

Two consumer pamphlets from the Elder Ed program
are available for distribution to the public. Entitled:
“You and Your Medicines’ and How to select Your
Pharmacy and Pharmacists’, these pamphlets are avail-
able by calling (301) 528-3243 or write Elder-Ed, 20 N.
Pine Street, Baltimore, Md., 21201.

Wanted: Pharmacist for retail store, downtown area near
Lexington Market: call 685-1948

Pharmacist, Maryland Licensed, Currently Enrolled in
post-graduate studies, desires full time summer position,
call 922-9212 between 7:00 p.m.-10:00 p.m.

HOTLINE NUMBERS FOR
IMPAIRED PROFESSIONALS
467-4224
796-844 1
685-7878
467-3387

Physicians —

Dentists
Attorneys
Nurses

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

JUNE, 1982

We at SELBY DRUG COMPANY
attribute our rapid growth and success
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The SELBY DRUG management

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633 Dowd Avenue
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CENTENNIAL MARKET

*Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

“Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

“The M.Ph.A. is offering to the public and its members
the USP publication, ‘““About your Medicine.” This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available— ‘About your
High Blood Pressure Medicine’’—$3.00 each plus $1.00
postage and handling.

*The Pharmacy Art Print ‘“Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

* Centennial Apothecary Jars with the Association's
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

31

SEPARATE BUT EQUALLY
INDISPENSABLE.

|

TWO VOLUMES.

Now more than ever, patients are turning to their drug dosage forms and brands. Volume II is a corres-
pharmacists for advice about drug products. That's ponding lay language guide for patients with instruc-
why more pharmacists around the country turn to tions on the proper use, precautions and side effects
USP Dispensing Information (USP DI) as the definitive — of their medicines.
reference for drug use information. Now the United In addition to the new two-volume D/, USP Is
States Pharmacopeia is offering a newly expanded offering the consumer paperback About Your
and updated edition, available for the first time as Medicines and a free kit of advertising and publicity
a two-volume set. tools to help you promote your patient education pro-

Volume |, designed for use by the pharmacist, con- gram. To order your copies, just mail in the coupon
tains detailed dispensing information on over 4,500 below.

Please send me the following: MAIL TO: Maryland Pharmaceutical Association

Quantity 650 W. Lombard Street

________: 1983 USP DI, each complete two-volume set, $37.95. * Baltimore, Metal ma coe

_______ Additional copies of USP D/ Volume ||, Advice for the Patient, at $17.95* each.
About Your Medicines Consumer Display Kit (12 lay language paperback books packaged in counter-top display
box), $36.00. (Suggested retail price $4.95.)

___—«d1980 USP XX - NFXV, $75.00* *; or $100.00* * with annual supplements.
Free Patient Education Program Promotion Kit.

Total Cost $ . Enclosed is my check or money order for $_____~~—~———spayable to USP, or charge my order to:
OVISA CO MASTERCARD AccountNumbe:L I LILI IU OOO OOOOUDOUoOo

Expiration Date: Signature: Pe
SEND TO: ADDRESS:

CITY: STATE: ZIP:

*Maryland residents add 5% sales tax. **Pennsylvania residents add 6% sales tax. 1983 USP Dis will be shipped in July 1982.

Chemically Impaired Pharmacists —
— Intervention Programs — Tony Tomasello
— An Overview of the Problem — Dudley Demarest, Jr.

Sales Tax in Maryland

Computers in Pharmacy: The Law Changes

—Angelique Kariotis

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 Nee

JULY 1982 VOL. 58 NO. 7

DAVID A. BANTA, Editor
CONTENTS BEVERLY LITSINGER, Assistant Editor

ABRIAN BLOOM, Photographer

3 President’s Message — Steven Cohen

: ‘ : Officers and Board of Trustees
4 Intervention Programs for Impaired Professionals — 987-83

Tony Tomasello, Pharm.B.S., M.S. Honorary President
WILLIAM J. KINNARD JR., Ph.D. — Baltimore

6 An Overview of the Impaired Pharmacist Problem President
and Solutions — Dudley Demarest, Jr. MABE OIN ENA Bs Jee Ueetaione

Vice-President

10>) Sales [ax in Maryland WILLIAM C. HILL, P.D. — Easton
Treasurer
13. Employer/Employee Relations Forum MELVIN RUBIN, P.D. — Baltimore
Executive Director
16 Computers in Pharmacy: The Law Changes — DAVID A. BANTA, C.A.E. — Baltimore
Angelique R. Kariotis Executive Director Emeritus

NATHAN GRUZ, P.D. — Baltimore

24 A Preview of 1981 Hospital Pharmacy Operations

: ; TRUSTEES
26 Procardia Review PHILIP H. COGAN, P.D. — Chaimnan
: Laurel
4)
27 Picture page RONALD SANFORD, P.D. (1985)
Catonsville
28 Abstracts JAMES TERBORG, P.D. (1985)
: Aberd
30 HCFA Releases Indicators tte)
GEORGE C. VOXAKIS, P.D. (1984)

Baltimore

DEPARTMENTS BARBARA BARRON, P.D. (1983)

Rising Sun, Maryland

CHERYL BETZ, SAPhA (1983)
Baltimore

20 Letters to the Editor
31 Classified Ads

EX-OFFICIO MEMBER
WILLIAM J. KINNARD, JR., Ph.D. — Baltimore

ADVERTISERS
Leet HOUSE OF DELEGATES
23 District Paramount Photo 9 Mayer and Steinberg Speaker
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8 Maryland News Distributing HARRY HAMET, P.D. — Baltimore

MARYLAND BOARD OF PHARMACY

Honorary President
Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN, P.D. — Salisbury
new address with zip code number. Allow four weeks for changeover. APhA member — ;
please include APhA number.

President
BERNARD B. LACHMAN, P.D. — Pikesville

The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore
part of their annual membership dues. Entered as second class matter at Baltimore, Mary- ANTHONY G. PADUSSIS. P.D. — Timonium

land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201.

PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

e THE MARYLAND PHARMACIST

President's Message

Guest Message

I am pleased to address Maryland Pharmaceutical Association as both a
member of MPhA and President of Maryland Society of Hospital Pharmacists
through this editorial.

As a new graduate I often questioned the purpose and the operation of
MPhA and M.S.H.P. Frankly, it took a number of years to begin to understand
the operation of these organizations. Now I find myself the President of
MRS TEP?

An obligation of these societies should be to make it easy for the new
pharmacist to contribute to his/her profession through society activity. There is
no doubt that there are many young practitioners who would serve if asked. I
am not talking about recruitment to fill the roster. I am talking about encourag-
ing these people to actively display their interest and talent to mold the future
of the profession. Therefore one of my goals for the coming year is to attract
and welcome the new pharmacist and the inactive pharmacist into society
life now. Hopefully I will be able to help develop a process through these or-
ganizations that will make it easier for the talented young people in our profes-
sion to contribute early in their careers.

One of the obligations of the profession through the society structure is
to develop the future leaders. With some effort on our part to attract and develop
these practitioners and efforts on the part of the new-or inactive professional
to contribute, the coming year should be more rewarding for all of us.

Thank you for allowing me to share these thoughts with you.

Bhd oo —

Steven §. Cohen, President

MARYLAND SOCIETY
OF HOSPITAL PHARMACISTS

Intervention Programs for
Impaired Professionals: Where
Are the Pharmacists?

by Tony Tommasello, Pharm.B.S., M.S.

About 70 percent of adult Americans drink alcohol
and of these about 6 to 10 percent develop alcoholism
(1). Taking this estimate at face value it can be
suggested that 180 to 280 of the 2,800 pharmacists in
Maryland are or will become alcoholic (2). Others will
become dependent on other drugs. However other re-
search indicates the presence of an apparent positive
relationship between alcoholism and higher educational
attainment (3) implying that the number may be at the
upper end of this range.

Other helping professions have taken a hard look at
these figures in their respective fields and have come up
with estimates of alcoholism in their colleagues. For
instance, it has been estimated that 13,600 to 22,600
physicans nationwide are or will become alcoholics, or
otherwise chemically dependent (4), and 40,000 to
45,000 are or will become impaired according to other
estimates (5). Physicians have led the professions in de-
veloping programs to aid a colleague who is suffering
from alcoholism or chemical dependence.

Concern for one’s colleague, assessment of need,
and expertise within the profession led to the develop-
ment of specific programs which reach out to impaired
physicians and offer help. While programs differ some-
what from state to state a basic tenent is that all
guarantee that intervention will not harm the physician
(6). The program is basically a networking system which
allows an individual to express concern about a physi-
cian whom they suspect may be impaired or have a
chemical dependency problem. The individual contacts
a special committee of physicians by telephone, his
name and phone number are taken and the committee
chairman calls him back. It is the chairman’s responsi-
bility to get pertinent clinical data to insure that inter-
vention is justified. The chairman may request that a
second caller contact him in order to verify the infor-
mation. Once a decision has been made to approach the
impaired physician, the chairman selects, from a body
of volunteers, two physicians who will visit the troubled
doctor. Their job is to talk with him, help him recognize
his problem, and recommend treatment. Many of the
volunteers are recovering from chemical dependence
themselves and are aware cf the sensitivity surrounding

4

this initial contact. The troubled doctor is in no way
obligated to see the volunteers. No records are kept and
no State boards are notified that a report has been
made.

In 1977 the New York State legislature passed a law
requiring that any physician who is aware of misconduct
on the part of another physician must report this to the
board of professional conduct. However a new law,
passed in April 1980, established a three year trial pe-
riod during which the impaired physician’s committee is
exempted from reporting. After this time the program
will be evaluated. The troubled doctor is well protected
since the New York physician’s committee will never
directly report him to the board of professional conduct
and the chairman is prohibited by law from giving in-
formation to the initial caller or anyone else not directly
connected with the case.

In Georgia the State Medical Association im-
plemented the Disabled Doctors Program in 1975. In a
five year period 297 physicians were contacted through
the program. 240 entered treatment and 57 were judged
to be inappropriate or rejected. A report of the program
indicates that 156 physicians have been successfully re-
habilitated and returned to practice (7). In Maryland
there are about 50 referrals per year from a base of
about 7,000 physicians. It is reported from the Hazelden
alcoholism treatment unit that the physicians’ response
to treatment is more favorable than for other patients in
the same unit (8).

Other health professions in the State of Maryland,
including nursing, dentistry and law, have instituted
programs modeled after the physicians’ program. It is
worthwhile to note that Maryland is considered a leader
in this field (6).

Research and experience have indicated that there
are several risk factors that are associated with alcohol
and drug abuse amongst health professionals. A long
standing hypothesis for high rates of physician drug use
is the legal accessibility of drugs (9). However recent
research findings implicate job stress as an equally if not
more important factor (9). Other common explanations
are overwork (10), physical ailment, poor self-concept,
high level of aspirations (11) and fatigue reduction (12). |

THE MARYLAND PHARMACIST

i

Whatever factors predate drug use, the effects of
alcoholism and other chemical dependency are devas-
tating not only to the individual but also to his family. A
survey of alcoholic physicians found that they suffer the
same medical consequences evident in the general
population of alcoholics (4). The Georgia program iden-
tifies six areas in the life of the alcoholic physician that
deteriorate as the disease progresses. Listed in order
they are: Community involvement, Family life,
Employment patterns, Physical status, Office conduct,
and Hospital duties (7).

There is so little research in this area with regards to
pharmacy that one can only make assumptions based on
the experience of the physicians’ programs. One can
only guess how pharmacists would respond to questions
which access stress such as ‘‘too much responsibility
for people’ and ‘‘work overload”’ or ‘‘lack of participa-
tion in decision making’’ (9). In spite ofthe lack of
specific data relating to pharmacy, the application of
general population statistics regarding alcoholism men-
tioned in the opening of this article signal a need for
action.

It is encouraging to note that within the past several
months some state boards of pharmacy and the Ameri-
can Pharmaceutical Association as well have begun to
focus on the impaired pharmacist. There is a common
understanding amongst these organizations that a non-
punitive approach to our colleagues in distress is pre-
ferred (13, 14, 15).

An immediate course of action is to begin educating
our colleagues about alcoholism and chemical depen-
dency in general. Significant advances are now taking
place at the University of Maryland at Baltimore in gen-
eral (13), and at the Pharmacy School in particular.
However an additional effort must be made to reach
pharmacists in practice through continuing education
programs.

Given the successful track record of professional
intervention programs it is suggested that the time is
right for launching a Pharmacists’ Program for Impaired
Professionals. The program would be designed along
the lines of the physicians’ program with particular em-
phasis on the helping aspects and a guarantee of confi-
dentiality for the troubled pharmacist.

Finally, research is sorely needed in this area to
characterize the specific needs of the Pharmacy profes-
sion in this area. Physicians have offered some
guidelines regarding specific research needs and meth-
ods (14).

REFERENCES

1. Cahalan D, Cisin IH, Crossley HM: American Drinking Prac-
tices: A National Study of Drinking Behavior and Attitudes,
Monographs of the Rutgers Center of Alcohol Studies, number 6.
New Brunswick, NJ, Publications Division. Rutgers Center of
Alcohol Studies, 1969.

2. Maryland Board of Pharmacy Figures

3. Efron V, Keller M, Gurioli C: Statistics on Consumption of Al-
cohol and on Alcoholism. New Brunswick NJ, Publications Divi-
sion, Rutgers Center of Alcohol Studies, 1974

4. Bissell L, Jones RW: The Alcoholic Physician: A Survey Am. J.
Psychiatry 133:10 1976

JULY, 1982

. Dixon WT: The Case of the Emotionally-Ill Doctor: Physician

Heal Thyself MD State Med. Journal Oct. 1980

. Nagy BR: Help for Impaired Physician New York State Medical

Journal Sept. 1981

. Talbott DG, Benson EB: Impaired Physicians: The dilemma of

identification. Alcohol and Drug Problems 68(6):Dec. 1980

. Kliner DJ, Spicer J, Barnett P: Treatment Outcome of Alcoholic

Physicians. Journal of Studies on Alcohol 41(11):1980

. Stout-Wiegand N, Trent RB: Physician Drug Use: Availability or

Occupational Stress? Int. J. Addiction 16(2):1981
Hill HE: The Addicted Physician Res. Publ. Assoc. Res. Nerv.
Ment. Dis. 46:321—322 1968

11. Winick C: Physician Narcotic Addicts Soc. Probl 9:174 — 186 1961

Watkins C: Amphetamine Usage by Medical Students S. Med. J
63:923—929 1970

. Whitfield CL: Medical Education and Alcoholism MD State Med.

J. Oct. 1980

. Warschawski P: The First International Symposium on the Im-

paired Physician MD State Med. J. Oct. 1980

. Lerner S. The Alcohol Impaired Pharmacist: The Profession

Needs A Policy American Pharmacy NS22 (4) 6—8 1982

. Whitfield CL: Medical Education and Alcoholism MD State Med.

J. Oct. 1980

. Warschawski P: The First International Symposium on the Im-

paired Physician MD State Med. J. Oct. 1980

The need for professional association recognition of
the impaired practitioner was first addressed over a year
ago. Since that time, not only has the American Phar-
maceutical Association pursued this issue, but many
state associations are actively working on local pro-
grams. This need for recognition first came to the atten-
tion of the Student American Pharmaceutical Associa-
tion in late 1980.

At that time a letter from a state board of pharmacy,
stating concern for the increased incidence of pharma-
cists appearing before the board for drug abuse related
problems was given to one of the student delegates to
the SAPhA Resolutions Committee. The committee,
meeting in January 1981, responded to that letter with a
proposed resolution entitled; *‘Assistance for Chemi-
cally Impaired Pharmacists’’ which read:

Be it resolved, that SAPhA strongly urges
that a preventative and rehabilitative program be
developed to assist emotionally impaired and/or
chemically dependent pharmacists.

Be it further resolved, that an educational
program be developed to enlighten pharmacists
in regard to this problem, its manifestations and
solutions.

The 1981 SAPhA House of Delegates had problems
with the wording of the resolution and referred it back
to committee. Before the new Resolutions Committee
reviewed the proposal in January 1982, the SAPhA
Executive Committee, seeing the need for such a reso-
lution, and the need for student input, placed it on the
agenda of each of the eight Midyear Meeting Policy
Proposal Forums, to gather individual student opinions.

At the same time various states formed task forces
and developed programs, in many cases with student
impetus, in most cases with student involvement. It was
partly because of SAPhA’s involvement and the trend in
the state associations, that the APhA placed the issue
on the agenda of its January Professional Affairs Policy
Committee. At that time the SAPhA Resolutions Com-
mittee reported to the policy committee on SAPhA’s
actions.

The committee also considered the steps being taken
by such states as lowa, Minnesota, and Maryland. The
following policy was adopted by the APhA House of
Delegates in April 1982 and its implementation awaits
the action of the Board of Trustees.

* Dudley is a graduating Pharmacy student who completed this
article as part of his special studies externship rotation in the Associa-
tion’s office.

6

An Overview
of the

Impaired Pharmacist—

Problem and
Solutions

by
Dudley Demarest, Jr.*

The Committee recommended the Adoption of the
following policy:

1. APhA believes that pharmacists should
not practice while subject to physical or mental
impairment due to the influence of drugs—
including alcohol—or other causes that might
adversely affect their abilities to function prop-
erly in their profession capacities.

2. APhA supports establishment of detec-
tion processes as well as counseling, treatment,
prevention, and rehabilitation programs for
pharmacists and pharmacy students who are
subject to physical or mental impairment due to
the influence of drugs—including alcohol—or
other causes, when such impairment has poten-
tial for adversely affecting their abilities to func-
tion properly in their professional capacities.

In the past year several states have begun intensive
study into the area of pharmacist impairment. Two of
the most active in the area are Minnesota and Iowa.

At their 1981 annual meeting the Iowa Pharmacists
Association established a task force on Impaired Phar-
macists. To date the actions of the task force have been
to set goals for their association’s program. The Min-
nesota program has been dubbed PAP’M, Pharmacists
Aiding Pharmacists in Minnesota.

Overall, many states are at various stages in devel-
oping programs. Many states have medical societies
with active programs. Kansas is considering joining the
medical society program. States such as Texas are

THE MARYLAND PHARMACIST

|

7

forming their own task forces to study the issue. North
Carolina has joined a program involved with health care
practitioner ‘‘well-being.”’

The move is on with the realization that pharmacists
and their associations need to be educated on the
psychological problems faced by the pharmacist as a
health practitioner.

The issue of the emotionally or chemically impaired
pharmacist has long gone unnoticed. It seems that the
attitude that the pharmacist, as a knowledgeable drug
expert, trained in the pharmacology of drugs and their
abuse potential, was at less risk of becoming impaired
as compared to his health care counter-parts, such as
physicians and nurses. This attitude pervades the pro-
fession and has limited any study into the problem.

At the time when SAPhA was considering policy on
the issue, research by SAPhA staff showed the general
lack of information on the well-being of pharmacists.
The information at our disposal was the undocumented
increase in pharmacists appearing before state boards of
pharmacy on charges of drug abuse. Overwhelming data
was available from the American Medical Association
on the problem and its solutions. It was also recognized
that an intra-professional program was needed to pro-
vide help to pharmacists in need, rather than a licence
suspension and revocation without aid.

Many state boards are seeing an increase in cases of
pharmacists practicing while impaired. Many schools of
pharmacy are experiencing the same problem. The rea-
son for this increase is not documented, and specula-
tions about the increase use and abuse of drugs are not
well founded. Suffice it to say that more are being re-
ported.

Much of the information on the susceptability of
health practitioners and the solutions to the problem
comes from the AMA’s approach to the issue. The
AMA viewed “‘‘accountability to the public through as-
surance of competent care’’ as the primary purpose of
any program. At the same time one cannot deny the
moral obligation the profession has to assist its mem-
bers with their problems as they relate to the practice of
that profession.

The AMA’s Council on Mental Health provides the
following guidelines (para-phrased here)

1. It is the physicians ethical responsibility to
recognize and approach a colleague’s inability to
practice by advising the impaired practitioner or
by following the sequence:

a) Discuss with others close to the physician

b) Refer to the staff or administration of a
hospital

c) Refer to a specific committee of the state
association

‘It should be (a committee) created exclusively
for (this) purpose, not an existing one, such as an
ethics or a grievance committee.”

d) To the licensing board
JULY, 1982

2. Spouses are helpful, the Women’s Auxiliary
should take an active role.

3. A model law should be written to deal with
the impaired physician.

4. Educational programs for medical students
emphasizing their high vulnerability to psychiat-
ric disorders, alcoholism, and drug dependence.

A recent study on pharmacists’ well-being, con-
ducted at the University of North Carolina, School of
Pharmacy, showed that employee pharmacists and the
“‘up and coming generations of practitioners ages
20— 39°’ show an increase risk for ‘“‘burn-out’” which
may lead to impairment. Another study with physicians
shows that the risk of impairment correlates not only
with accessibility to drugs but with the level of stress
experienced by the practitioner.

Here at the University of Maryland, it has long been
recognized that there is a general lack of pharmacy edu-
cation in the area of drug abuse. This was one of the
reasons that the Student Committee on Drug Abuse
Education was formed. Educating pharmacists as well
as students and spouses is paramount in any program
aimed at helping the impaired pharmacist.

One of the problems encountered when discussing
the impaired pharmacist issue concerns the definition of
the term impaired. Many people find the word offensive
and harsh, yet a more all-encompassing term is difficult
to find. The AMA provides this definition:

(The impaired practitioner is) one who is unable
to practice with reasonable skill and safety to
patients because of physical or mental illness,
including deterioration through the aging pro-
cess, or loss of motor skills, or excessive use or
abuse of drugs, including alcohol.

Maryland is well on the way to becoming one of the
primary states in its approach to aiding the impaired
pharmacist. But there is still one problem that every
state must face and that is the problem the AMA has
labeled ‘“‘the Conspiracy of Silence.’ People tend to
ignore a problem, hoping it will go away. Pharmacists
must recognize that the first step in aiding a fellow
pharmacist is to acknowledge the problem, contact
people who can help, and provide that needed step in
the delivery of care.

BIBLIOGRAPHY

1. Palerea, Edgar R: Helping impaired physicians. American Medi-
cal News Vol. 24, No. 27, July 17, 1981.

2. Report of the Council on Mental Health: The sick physician.
JAMA Vol. 223, No. 6, Feb. 5, 1973.

3. Ciacco, Eliz A, et al: The well-being of practicing pharmacists (to
be printed in the May issue of American Pharmacist).

4. Lutz, Sue: IPA’s Task force on impaired pharmacists. lowa
Pharmacist Vol. 37, No. 2, Feb. 1982.

5. Stout-Wiegand, Nancy, et al: Physician Drug Use; Availability or
occupational stress? The International Journal of the Addications
Vol. 16, No. 2, pp. 317—330, 1981.

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profitable it can be.

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and it should be expanded.

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(301) 233-4545

THE MARYLAND PHARMACIST

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MAYER and
STEINBERG

Insurance Agents & Brokers

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MAYER and STEINBERG INSURANCE

AGENCY GIVES A DIVIDEND CHECK TO

RONALD A. LUBMAN EVERY YEAR! Usually
for more than 20% of his premium.

RONNY is one of the many Maryland phar-
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For Your Information

Sales Tax in Maryland

Sales of tangible personal property in Maryland are
presumed subject to sales tax unless specifically ex-
empted or excluded from the tax by statute. The follow-
ing paragraphs describe several exemptions in the statute,
accompanied by lists of items which do not fall within
the requirements for claiming the exemption. Sales of
these items are, thus, subject to sales tax unless exempt
or excluded under another provision of the statute, for
example, as a sale for resale or a sale made to an or-
ganization exhibiting a sales tax exemption certificate.

Food

The Retail Sales Tax Act provides several exemp-
tions for sales of food for human consumption, including
sales of food for less than $1.00. The Act also provides
a specific definition of ‘‘food’’. The following list con-
tains illustrative examples of items which are not ‘‘food”’
under this definition, the sales of which, therefore, do
not qualify for any of the exemptions for sales of food.

Alcoholic Beverages Fudge Mix
Bottled Water Ice

Candy Marshmallows
Candy-Coated Peanuts Peanut Brittle

Caramel Popcorn Pet Food

Chewing Gum Roll Candy

Confections Soft Drinks in Unopened
Dietetic Candy Containers

Agricultural Supplies

The Retail Sales Tax Act provides an exemption for
the sales of certain enumerated items for agricultural
purposes. The following list contains illustrative ex-
amples of items which are not included in this exemp-
tion, the sales of which are, therefore, subject to tax.

Bird Seed Grass Seed
Christmas Trees House Plants
Fertilizer for Lawns Shrubbery
Flowers Wreathes
Garden Tools and

Equipment

A vendor may not charge sales tax on any sale of trees,
shrubbery or sod where he is obligated to plant or install
these items. A vendor purchasing trees, shrubbery or
sod for the purpose of resale on an installed basis shall
pay the tax based on the purchase price of the item.

10

Medicine and Medical Supplies

The Retail Sales Tax Act provides an exemption
from the tax for sales of medicines, medical supplies
and sickroom equipment. The following list contains
illustrative examples of items which are not medicine,
medical supplies or sickroom equipment, as those terms
are defined by regulation, the sales of which are, there-

fore, subject to tax.

Athletic Supports
Breath Fresheners

Contact Lens Cleaning

Solutions
Cosmetics
Denture Adhesives
Deodorants
Disinfectants
Hair Care Products
Heating Pads
Hot Water Bottles

Pregnancy Detection Kits

Prophylactics

Sanitary Napkin Belts

Skin Creams and Lotions

Sleep Suppressants

Sunglasses
(non-prescription)

Suntan Lotions

Talcum Powder

Toothbrushes

Toothpastes

Vaseline (plain)

Miscellaneous Items

Sales of the following items are also taxable unless
purchased for resale or otherwise exempt by statute, for
example, as a sale to an exempt entity.

Air Fresheners
Anti-Freeze
Appliance Rentals
Baby Bottles
Brooms

Brushes

Bug Sprays
Cameras

Candles

Charcoal Briquettes
Cleaning Products
Clothing

Dishes

Disposable Diapers
Dyes

Eating Utensils
Film

Film Developing
Furniture
Glassware

Glue

Greeting Cards
Hardware

Jewelry

Kitchen Utensils
Lighter Fluid
Linens

Lubricating Oils
Luggage

Magazines

Mops

Motor Oil

Musical Instruments
Paper Products
Photographic Supplies
Polishes

Pots and Pans
School Supplies
Shaving Products
Smoking Deterrents
Sponges

Sporting Goods
Stationery

Tobacco, except cigarettes
Toys

Water Softeners
Waxes

THE MARYLAND PHARMACIST

Additional information concerning this Bulletin or
the taxability of items not contained in these lists may
be obtained from Taxpayer Service Section by tele-
phone at (301) 383-3800 or by letter to the above address.

19 Dusting Powder (Surgical)

19 E.K.G. Paper and Jelly

19 Ear Basins

19 Electrode Jelly

19 Emesis Basins

19 Envelopes, Pill—Given to patient by doctor
19 Ethyl Chloride

19 Evacuating Syringe

20 Exercise Bar (Medical)

19 Eye Wash Cups

19 First Aid Kits

19 First Aid Station at Plants and offices, sales to
20 Flotation Pad (Medical)

19 Forceps (All types)

19 Gamophen Soap

19 Gastric Tubes

19 Gauze

19 Gloves, Plastic (Disposable)
19 Gloves, Rubber

20 Grab Bar—Bathtub (Medical)
19. Gravity Tubes

19 Gynecological Instruments
19 Health Garments

19 Heating Neck Collars

19 Heating Pads

19 Holmspray Insufflator

20 Hospital Beds

20 Humidifier (Medical) only

20 Hydro-Hot-Pack (Medical)
19 Hydrocolation Steam Pack
19 Ileostomies

19 Incontinent Pants (Baby)

19 Instruments

19 Kerlix Rolls

19 Kleenex

20 Knee Braces

Lamps, Treatment

19 Lubricating Jelly for Glass Eye
20 Mattresses (Medical only)

19 Medicine Tubes (Disposable)
19 Medicine Tubes (glass)

19 Modess

19 Mucus Trap

19 Murphy Saline Tubes

19 Nasal Tips

19 Needle and Suture (Disposable)
19 Needles

19 Nursing Bottles

19 Obstetrical Instruments

19 Orthopedic Appliances

19 Oxygen (Non-Medical)

20 Oxygen Inhalers

20 Oxygen Kits

20 Oxygen Tents

20 Oxygen—Therapy Equipment
19 Ozium Spray

19 Pads—Absorbent

20 Pads, Alternating Pressure (Medical)
20 Pads, Crutch (Medical)

20 Pads, Flotation (Medical)

19 Pads, Heating

20 Pants, Incontinent (Medical)
19 Paper Slippers

19 Patient Helper

19 Pel-Toner

19 Pelvimeter

20 Pessaries

19 Pharmaceutical Equipment
19 Plastic Disposable Gloves

ibe Prostatectomy Instruments
19 Rectal Sets

A—Exempt

B—Taxable

C—Exempt to doctors only when used as medical supplies for
treating patients

19 Abdominal Supporters

19 Absorbent Cotton

19 Adhesive Tape

19 Airways (Disposable)

19 Antiseptics

19 Alconox

19 Applicators (Wood)

20 Arm Pads

20 Arm Slings

20 ~~ Artificial Limbs

19 Axis Traction

19 B. P. Blades

19 Baby Scales

19 Bandages, Gauze and Plaster
20 ~+Bath Bench (Medical)

20 Bath Lift (Medical)

19 Batteries, other than hearing aid
20 Bed Cabinets

19 Bed Canopies, mattress, rail
20 Bed Pans

19 Bed Wetting Alarms

20 Bedside Rails

19 Berman Tubes

19 Blood Bottles (one time use)
19 Bottles, medicine given to patient by doctor
19 Boxes, pill, given to patient by doctor
20 Braces, Arm, Leg, Spinal

19 Breast Pumps

20 Canes for Blind

Catheters (Disposable)

19 Cervical Collars

19 Cervical Scrapers

19 Cevitamic Acid

20 Chair—Table (Medical)

19 Chloroform

19 Chlorophenyl

19 Chux

19 Circumcision Shield

19 Clothing, Medical

20 Colostomy—Equipment

20 Colostomy—Supplies

19 Combine Pads

20 Commode Chairs

20 Commodes, Bedside (Medical)
20 Corsets, on doctors prescription
19 Cotton Balls

19 Cotton (Surgical)

19 Cover Glasses

20 ~~ Crutches

19 Cystoscopes

19 Deodorant used on patient
19 Diagnostic Equipment

19 Diagnostic Testing Material
19 Dialators

19 Diapers (Disposable)

19 Doctors Bags

19 Drainage Pads

19 Drainage Tubes (Disposable)
19 Drugs and Medicine

JULY, 1982

WWOAWPFWWWOPOPP PPAF PPP UOPWWDDOSFWDPFODONSSUPONOOMWSOPSPSPSPUCDTOWHSFWONOSFUOSPOPrrOmwrsarrradarndy
Ro

SrPrWDWOW>FWDWDSOS SSP rrr PSFWUWPSOPS PrP POSFUPBUBDNOS SPP ePTPSrrPTMyS rr rPUODS Sry
©

By Jake Miller, Pharmacist
Manager, Professional Relations
A.H. Robins Company, Inc.

Changing with
the times. . .

Minor labeling changes will be showing up soon on
many familiar “front end” products in your pharmacy as
a result of the most extensive reorganization in A. H.
Robins Company’s history.

Our Miller-Morton subsidiary has been merged into
the Company and its marketing activities for Sergeant’s®
pet care products, Chap Stick® lip balm and Quencher®
cosmetics are now included in anew Consumer Products
Division. In addition, the Robitussin® family of cough
preparations, the Allbee® with C family of vitamins
(including Z-BEC® Tablets), Dimetane® and Dimetane®
Decongestant Tablets and Dimacol® Capsules have
been shifted from the Pharmaceutical Divison to this
new unit.

— Creation of the new Consumer
Products Division reflects to a large

's degree our Company’s success in
—« promoting sales of consumer health
care products during the last sev-
_ eral years and represents an effort
by A. H. Robins to better position
A.H. Robins Consumer itself to respond to changes in the
brands ... together after PUrChasing habits of its various
a major reorganization. classes of customers. The division
will have its own sales force, divided between a health
care/cosmetics department and a pet care department.

The shift of consumer health care products will
permit our Pharmaceutical Division to concentrate on its
traditional mission of marketing ethical pharmaceuti-
cals. With new products flowing from our Research and
Development Division and augmented by the injectable
products produced by our Elkins-Sinn subsidiary, the
Pharmaceutical Division’s sales force can spend more
time visiting doctors offices, pharmacies and hospitals,
working to accomplish the basic goal of stimulating
prescriptions for the products in our line.

A. H. Robins has long been recognized as having
one of the best sales forces in the pharmaceutical in-
dustry. From the Company’s new position of effective-
ness, this group of more than 500 men and women,
many of whom are Certified Medical Representatives,
will be able to provide even better service for you and
your patient.

ahi ; AH ROBINS

A. H. Robins Company
Richmond, Virginia 23220

DAAAS SF ROS FOAM OMPS SPS OMDDBDOWSOONDSOS SUDO SUCBBDDPOIIS SHS SPS ePSOSOBAIPS STP

Restraints

Rubber Stockings

Rubber Tubing

Sacro Lumbo Supports
Safety Toilet Frame (Medical)
Sanette Bags

Scissors (all types)

Scrapers (Wood)
Septisol—Liquid Soap

Sera Sharp

Sheet Holders

Sheet Wadding

Sick Room Equipment

Silver Nitrate Solution

Soap (Surgical)

Splints

Sponges (Disposable)

Spray Bandages

Steel Gauze (Disposable)
Steel Wire (Surgical)

Steri Pads

Sterilizing Aids

Sterilizing Equipment
Sterilizing Solutions and tablets
Stethoscope Tubing

Surgi Lubes

Sutures

Syringe Bags

Syringes

Syringes (Disposable)

Table, Over bed (Medical)
Table Paper

Toilet Seats, Raised (Medical)
Tourniquets

Towels (Paper) used on patient
Trachea Tubes (Disposable)
Trapeze Bar (Medical)
Trephine Set

Truss

Tubes, Gastric

Tumor Screw

Umbilical Buttons

Umbilical Cord Clamps
Urinal Bags

Urinals

Urinary Appliances

Urine Specimen Bottle
Urolicide

Utility Sheets (Cloth)

Utility Sheets (Paper)
Walkers

Walking Heels

Waxed Bags

Wheel Chair Accessories (Invalids)
Wheel Chairs for Sick

Wood Applicators

X-Ray Developing Chemicals
X-Ray Film

Zephiran Chloride

THE MARYLAND PHARMACIST

a ee ee

EMPLOYEE—EMPLOYER
RELATIONS FORUM

The purpose of the Forum is to deal creatively with the issues in Maryland Pharmacy employer and
employee relations. This Committee of the Association is made up of individuals from a wide variety
of practice settings. We are asking for input on current employment issues from all segments of the
profession. The Forum will act as a ‘sounding board” on these issues and will provide some

ombudsman activity.

Model Employment
Agreement

The Employer-Employee Relations Forum feels that
a clear understanding of the Employment Relationship
is necessary to prevent misunderstanding by either the
Employer or Employee Pharmacist. The Forum feels an
agreement between the Employer and Employee Phar-
macist, whether it be an informal verbal agreement or
highly structured formal contract, is necessary for a
mutually satisfying relationship.

The Forum therefore presents, as a service to the
members of the Maryland Pharmaceutical Association,
a list of job-related items which should be considered
and discussed at the time of employment by the
employer and employee pharmacist.

1. Job Description. The Pharmacist should have a
clear understanding of the duties, responsibilities, and
authorities that will be expected as part of the employ-
ment. In some cases employer may wish to provide a
‘Policy Manual’’ that will outline operating procedures
for the employee pharmacist. This will allow both
employer and employee to measure performance
against an established criteria.

2. Length of Employment. In most instances the
length of employment will be indefinite. However, the
following should be discussed:

a. Length of the ‘‘Probationary Period’”’ if any.

b. The duration of the agreement, if any.

c. The conditions under which the agreement
may be re-negotiated.

3. Compensation. As part of the compensation
package, some of the following may be considered:

a. salary (hourly or weekly)

b. overtime

c. Bonus and/or profit sharing. The method of
arriving at such a figure should be pre-determined and

agreed upon.
4. Benefits. Without intending to be all inclusive the

JULY, 1982

following list of possible employment benefits is pro-
vided and if available should be clearly understood:
. vacation
. sick leave
. professional society membership
. continuing education
. health insurance
Life insurance
. professional liability insurance
. income protection insurance
. retirement plan
. stock purchase options
. personal purchases-employee discounts
. professional attire
m. court time Gury duty, witness)
n. funeral leave

5. Schedule. While allowing for flexibility, an un-
derstanding should be reached regarding the general
hours to be worked, shifts, and procedure for requesting
alterations of the standing schedules. In addition, it is
helpful to know specifically which days will be consid-
ered holidays.

6. Practice Limitation. In some practices an
employee may wish to stipulate that the employee
pharmacist may not work for another employer in a
relief or part-time position.

7. Arbitration of Disagreements. It may be helpful
to provide a description of the manner in which dis-
agreements can be resolved. The employer-employee
relations forum will not serve as a formal arbiter, but is
available to make recommendations for arbitration.

8. Termination. The agreement may be formal or
informal, but the amount of notice (and/or severance
pay) should be specified.

In conclusion, we cannot emphasize enough the im-
portance of regular, open communication between the
employer and employee.

13

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JULY, 1982 15

Computers in Pharmacy:
The Law Changes

by Angelique R. Kariotis

Angelique is a graduating Pharmacy student and researched and completed this article as part of a special studies externship

rotation at the Association Office.

The Age of Computers is no longer a dream, but a
part of the present time period we live in. Computers in
pharmacy help expedite prescription processing, in-
ventory control, third party billing and price updates,
allowing the pharmacist ‘‘time’’ to manage the store,
solve pharmacy problems and interact more with pa-
tients.

With the increase in the usage of computers in
pharmacy, it became necessary to alter various policies
and procedures within the law, within billing and within
patient confidentiality. These changes are available for
reference, but are in scattered form, therefore, a small
attempt was made to compile as much information as
was obtainable.

Changes in the Maryland Pharmacy Law are re-
garding the transfer of prescription records. They are as
follows:

.04 Computer Transfer of Prescription Records
between Pharmacies

A. A computerized transfer system shall satisfy the
requirements of these regulations for prescrip-
tion transferral.*

B. Stores which access the same prescription rec-
ords electronically, such as independent phar-
macies using a jobber data bank, are not re-
quired to cancel the original prescription.

C. Pharmacies under a single ownership which
electronically access the same prescription rec-
ords are not required to cancel the original pre-
scription.

(Reproduced from the Maryland Pharmacy Law book,
1981: pages 199—200)

The Federal Drug Enforcement Agency has devel-
oped changes in their Controlled Drugs Substance refill-
ing of prescriptions. They are as follows: (reproduced
from the USP XX/NF XV Supplement 3:X pages
33235332)

* These regulations include cancelling the original prescription by
indicating that it was transferred, to whom it was transferred, the date
of the transfer, the names of the transferring pharmacist and the
pharmacist receiving the prescription.

16

(a) As

1306.22 Refilling of Prescriptions

an alternative to the procedures provided by

subsection (a), an automated data processing
system may be used for the storage and retrieval
of refill information for prescription orders for
controlled substances in Schedule III and IV,
subject to the following conditions:

(1)

(2)

(3)

Any such proposed computerized system
must provide on-line retrieval (via CRT dis-
play or hard-copy printout) of original pre-
scription order information for those pre-
scription orders which are currently autho-
rized for refilling. This shall include, but is
not limited to, data such as the original pre-
scription number, date of issuance of the
original prescription order by the prac-
titioner, full name and address of the patient,
name, address, and DEA registration number
of the practitioner, and the name, strength,
dosage form, quantity of the controlled sub-
stance prescribed (and quantity dispensed if
different from the quantity prescribed), and
the total number of refills authorized by the
prescribing practitioner.

Any such proposed computerized system
must also provide on-line retrieval (via CRT
display or hard-copy printout) of the current
refill history for Schedule III or IV controlled
substance prescription orders (those autho-
rized for refill during the past six months).
This refill history shall include, but is not
limited to, the name of the controlled sub-
stance, the date of refill, the quantity dis-
pensed, the identification code, or name or
initials of the dispensing pharmacist for each
refill and the total number of refills dispensed
to date for that prescription order.
Documentation of the fact that the refill in-
formation entered into the computer each
time a pharmacist refills an original prescrip-
tion order for a Schedule III or IV controlled
substance is correct must be provided by the
individual pharmacist who makes use of such
a system. If such a system provides a hard-

THE MARYLAND PHARMACIST

(4)

copy printout of each day’s controlled sub-
stance prescription order refill data, that
printout shall be verified, dated, and signed
by the individual pharmacist who refilled
such a prescription order. The individual
pharmacist must verify that the data indicated
is correct and then sign this document in the
same manner as he would sign a check or
legal document (e.g., J. H. Smith, or John H.
Smith). This document shall be maintained in
a separate file at that pharmacy for a period of
two years from the dispensing date. This
printout of the day’s controlled substance
prescription order refill data must be pro-
vided to each pharmacy using such a comput-
erized system within 72 hours of the date on
which the refill was dispensed. It must be
verified and signed by each pharmacist who is
involved with such dispensing. In lieu of such
a printout, the pharmacy shall maintain a
bound log book, or separate file, in which
each individual pharmacist involved in such
dispensing shall sign a statement (in the man-
ner previously described) each day, attesting
to the fact that the refill information entered
into the computer that day has been reviewed
by him and is correct as shown. Such a book
or file must be maintained at the pharmacy
employing such a system for a period of two
years after the date of dispensing the appro-
priately authorized refill.

Any such computerized system shall have the
capability of producing a printout of any refill
data which the user pharmacy is responsible
for maintaining under the Act and its imple-
menting regulations. For example, this would
include a refill-by-refill audit trial for any
specified strength and dosage form of any
controlled substance (by either brand or
generic name or both). Such a printout must

Amount of time to
keep signature logs

indicate name of the prescribing practitioner,
name and address of the patient, quantity dis-
pensed on each refill, date of dispensing for
each refill, name or identification code of the
dispensing pharmacist, and the number of the
original prescription order. In any comput-
erized system employed by a user pharmacy
the central recordkeeping location must be
capable of sending the printout to the phar-
macy within 48 hours, and if a DEA Special
Agent or Compliance Investigator requests a
copy of such printout from the user phar-
macy, it must, if requested to do so by the
Agent or Investigator, verify the printout
transmittal capability of its system by
documentation (e.g., postmark).

(5) In the event that a pharmacy which employs
such a computerized system experiences
system down-time, the pharmacy must have
an auxiliary procedure which will be used for
documentation of refills of Schedule III and
IV controlled substance prescription orders.
This auxiliary procedure must insure that re-
fills are authorized by the original prescrip-
tion order, that the maximum number of re-
fills has not been exceeded, and that all of the
appropriate data is retained for on-line data
entry as soon as the computer system is
available for use again.

The State and Federal DEA consider the refills part
of the original prescription and therefore must be acces-
sible for inspection and are to be maintained for the life
of the prescription. In the State of Maryland, prescrip-
tions are to be kept five years after the date of dis-
pensing the appropriately authorized refills.

Third party insurance prescription providers offer
changes in the processing of third party claims generat-
ed by tape or by computer printout. Listed below is the
information provided by the various companies answer-
ing our request.

Blue Cross

Medical Assistance

Associated Prescription
Service

Prescription Drugs, Inc.

Iron Workers

Group Services Corporation

Pharmaceutical Card System

Metropolitan

(for tape billing and
computer hard copy)

3 years

N/A
2-3 years

7 years

No time specified.

No time specified

Life of the prescription
(in Maryland 5 years)

No time specified

Acceptance of Tape billing
tape billing turnover Audits
Yes 2-3 days Verify original prescription
on file and the signature.
Yes 10 days No, unless suspect fraud.
Yes. Claim there are a 7 days Verify the original prescrip-
great many errors tion and printouts for the
with this method. refills.
Yes No time Verify the original prescrip-
specified tion.
No N/a No audits
No N/A No audits
No N/A Audits are done as deemed
appropriate.
es 7 days Audits are performed at

random.

aa aR Me te Fe Protein ts eis ie 2 st Be erase tek A RG ae 2 See Be eS
Please note: Many of these companies were reluctant to furnish information either by phone or by mail, therefore, the above information
is as accurate as the person answering the questions would attest to.

JULY, 1982

17

One of the more controversial issues regarding com-
puterized pharmacy is patient confidentiality. With
computers, information is accessible to any person hav-
ing the simplest knowledge of turning a computer on.
Information can be altered or lost by someone misusing
the computer. The Medical and Chirurgical Faculty of
the State of Maryland recommends limited access to
computerized records. They recommend some type of
security or code system be built in such as alarms or
passwords that only few people have access to.

Computer companies require their personnel sign a
statement that as an employee of the company, they
will exercise caution in handling store files, including
patient and financial information, and not to discuss
these files with anyone or alter these files, except to
correct errors in the program. This data is private, privi-
leged information.

Computers improve the practice of pharmacy. Now
laws and procedures must be improved. As the utiliza-
tion of computers increases, so will the need to make
changes in policies and procedures. There will come a
time when these policies and procedures will be stan-
dardized and finally written down in one place!!!

Special acknowledgments of thanks belong to the
third party companies, 3 PM, Inc., Health Care Logis-
tics, the Law School at the University of Maryland, the
Maryland Board of Pharmacy and anyone else I hap-
pened to hassle in this endeavor.

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ALCHEMY SYMBOLS AND THEIR MEANINGS

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THE MARYLAND PHARMACIST

CELEBRATE WITH US

To commemorate its 100th anniversary celebration, the Maryland Pharmaceutical Association is issuing
a special edition, custom designed apothecary jar. For a limited time only, members and friends are
invited to purchase these deluxe containers in recognition of the association's first century of service.

Each glass jar is imprinted with a two-color reproduction of the Maryland Pharmacy banner and the
words: “Honos, Firmus, Purissimus —- Pharmacy, the Maryland Pharmaceutical Association — 1882-
1982.” The jars are suitable for home or office because of their wide variety of uses:

* For countertops — to store herbs, food-
stuffs
For desktops — to contain candy or dried
fruit
For occasional tables — to preserve
snacks or to use as a decorative acces-
sory
No matter how you choose to use this handy
apothecary jar, you will often welcome its
attractive styling and utility. This jar is not
available at any retail store! It has been de-
signed especially for the association and is
destined to become a collectors’ item in the
years ahead. Priced right for the value, you
can save by ordering three or more:

$12.00 — each
$33.00 — for three — $11.00 each
$100.00 — for ten — $10.00 each

Take advantage of this offer now. Simply
complete the order form below and mail it
to:

MhA

650 West Lombard Street

Baltimore, MD 21201

APOTHECARY JAR ORDER FORM

Name i squires BB Quantity -

Address. iets S48 Ss $i) ee Amount Enclosed $

DO NOT SEND CASH

Telephone

Return to: MPhA, 650 West Lombard Street, Baltimore, MD 21201

POLY, 1982

LETTERS ae”

MESSAGE FROM GOVERNOR HARRY HUGHES:

I am pleased to send greetings to all of those attend-
ing the special commemorative meeting of the Maryland
Pharmaceutical Association at the Kelly Memorial
Building.

Let me also take this opportunity to congratulate the
association, as you celebrate the centennial anniversary
of your founding.

The Maryland Pharmaceutical Association has
compiled an impressive record and remarkable growth
since 73 pharmacists united to serve the public interest
in 1882. On behalf of our fellow citizens, I commend you.

Although I am unable to be with you, I did not want
this special occasion to pass without sending my best
wishes for continued success.

Sincerely,
Harry Hughes
Governor

Dear Mr. Banta,

I wanted to take a moment to thank you, Beverly,
and the Employee-Employer Relations Comm. for
keeping me well-informed of all the committee’s activ-
ities. Regretfully, I am committed to working each
Tuesday, and have been unable to resolve this time-
conflict. I would like to commend the committee mem-
bers on the excellent work accomplished so far. The in-
formation they have compiled will be most useful to
both new pharmacists, as well as we ‘‘veterans’’ faced
with an unfortunate amount of transience in employ-
ment. I am looking forward to further correspondence,
and hope to participate more actively in the association
in the future. Thanks again.

Sincerely,
Gloria Rosensweig

Dear Mr. Banta:

Through the participation of Maryland pharmacists
and the support of the Maryland Pharmaceutical Asso-
ciation, the Drug Product Problem Reporting Program
(DPPR) continues to take concerns with drug products
used in pharmacy practice to the officials in govern-
ment and industry who are in a position to act upon
these concerns.

I would like to call your attention to a program that
is similar to the DPPR. It is the Medical Device and
Laboratory Product Problem Reporting Program. Medi-
cal devices, such as walkers, crutches, canes, ostomy
supplies, humidifiers, various types of thermometers,

20

contraceptive diaphragms and supplies, denture sup-
plies, wheelchairs, hearing aids, blood pressure moni-
toring devices, dietary supplements and biologicals may
also develop problems. Pharmacists encounter many of
these products in their practice and they are in an ex-
cellent position to observe the products and any asso-
ciated problems. However, the products fall under the
jurisdiction of a myriad of government agencies and
bureaus and it can be difficult to determine who is re-
sponsible for the various products. The USP Practitioner
Reporting System can simplify the process, because
USP will determine the appropriate agency and forward
the report to that office.

In 1973, the Medical Device and Laboratory Pro-
duct Problem Reporting Program (PRP) was initiated to
provide the opportunity for health practitioners to re-
port problems or concerns with medical devices, diag-
nostic equipment and/or in-vitro products. The PRP is a
practitioner oriented system in that it communicates
health hazards and product problems to appropriate
government and industry officials through the United
States Pharmacopeia and provides the reporter with a
response.

When a pharmacist encounters a problem with any
medical product, the pharmacist should state their ob-
servations on either the DPPR or PRP reporting form
and return it to the USP. The problems may also be re-
ported via the toll-free telephone line (1-800-638-6725).

If the pharmacist is not sure about the significance
of a problem, he/she is asked to report it. Problems that
appear insignificant at the time may be occurring with
other practitioners, and a pharmacist’s report could be
the additional information that initiates a corrective ac-
tion for a problem.

The USP Problem Reporting System is voluntary.
There is no cost associated with participation in the
program.

I have enclosed materials on the Medical Device
and Laboratory Product Problem Reporting Program. I
hope you will find it of interest and value. I would like
to ask the Maryland Pharmaceutical Association to con-
sider becoming a cosponsor of the Medical Device and
Laboratory Product Problem Reporting Program.

If you have any questions, please contact me.
Thank you.

Sincerely,

Robert Moore

Project Coordinator
Practitioner Reporting System

THE MARYLAND PHARMACIST

Dear Mr. Banta:

We wish to respond to the misunderstanding which
resulted from our outside counsel’s oral argument be-
fore the United States Supreme Court in the Jves vs.
Inwood Laboratories and Darby Drugs, et al. cases.

We want to assure you that Ives has the highest
regard for the pharmacy profession and in no way in-
tended to impugn the integrity of the nation’s pharma-
cists who play a key role in the health care industry and
are highly principled and honorable. A complete reading
of the brief and the evidence before the Supreme Court
reveals that our outside counsel’s comment was made
to, and considered by the Court only in the context of
the evidence before it of illegal substitution by certain
pharmacists, and was not intended to refer to the pro-
fession of pharmacy generally. Such evidence was im-
portant to our litigation in an effort to stop the market-
ing of ‘look-alike’? pharmaceutical products.

We feel that any instance of illegal substitution
and/or mislabeling is wrong, and we are sure that all
pharmacists agree with us. Indeed, the profession is in-
volved in efforts to stop this practice through the activ-
ity of their state boards of pharmacy.

Our litigation is directed against those generic man-
ufacturers who attempt to duplicate the color, shape
and size of our trademarked products.

From a realistic viewpoint, both pharmacists and
Ives share a vital common goal, i.e. to provide the pub-
lic with high-quality pharmaceutical products in order to
optimize patient care. In line with this common goal, it
is unthinkable that our company would have even con-
sidered criticizing the pharmacy profession in general.

We deeply regret any misunderstanding which may
have resulted from this matter. Ives is most anxious to
correct any misinformation, and to publicly proclaim
our deep respect for the nation’s pharmacists.

Sincerely,
Sidney Elston
Chairman, Ives

Dear Mr. Banta:

We are pleased to announce that effective June 1,
1982, Merrell Dow Pharmaceuticals Inc. will exclu-
sively market Bricanyl® (terbutaline sulfate) tablets and
ampuls, formerly supplied by Astra Pharmaceutical
Products Inc.

Please contact your Merrell Dow representative if
you have any questions, or contact me directly.

Sincerely,
Charles D. Combs
Director Trade and Professional Relations

JULY, 1982

ANNOUNCEMENT

Two Maryland Pharmacists, both members of
the Association, have announced that they will
seek election to the Maryland General Assembly.
They are: Don Elliott, owner of New Windsor
Pharmacy who is seeking a seat in the House
of Delegates, and William Skinner, Chairman of
the Centennial Celebrations Committee, a Phar-
macist and Attorney, seeking a seat in the Senate.

If you are interested in assisting in the cam-
paigns of these two pharmacists, contact the
Association office. There are currently no phar-
macists in the Maryland General Assembly while
several other health care disciplines are well
represented. The Legislative Committee urges
members to actively support these candidates
for office who will represent the pharmacy view-
point.

ACTUAL SIZE
Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the “P.D.” designa-

tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
Maryland Pharmaceutical Assn.
650 W. Lombard St.
Baltimore, Md. 21201

21

Do
you know a

pharmacist who
has won this Upjohn
Achievement Award?

Each year it is awarded to the out-
standing seniors in colleges of phar-
macy throughout the country.

Selection of the recipients is
made by the college faculties based
on community service or scholas-
tic achievement. We provide the
plaques and a stipend.

In the 10 years of this program
some 700 pharmacy seniors have
received this award. As pharma-
cists, ourselves, we appreciate what
these seniors have accomplished.
We feel they should be honored and
further motivated.

It is exciting to consider the
contributions these fine
young pharmacists will

make to society

in the years

ahead.

©1982, The Upjohn Company, Kalamazoo, Michigan

Governor Harry Hughes (center), Jim Clark, Jr., President of the
Senate (left), and Ben Cardin, Speaker of the House of Delegates
(right) sign into law the Association sponsored bill which repeals
the mandatory price poster effective July 1, 1982.

Gayle Stier (left), a fourth year pharmacy student, received the
M.Ph.A. Scholarship Award and Angelique Kariotis (right), a
graduating pharmacy student, received the Kaufman Award from
M.Ph.A. President Milton Sappe.

iii.
After the Association was informed that the Kelly Building would Brian Sanderoff (left) and Angelique Kariotis confer with Donald
not be moved or destroyed to make room for the expansion of Fedder (right), the SAPhA Faculty adviser at the Las Vegas-A.Ph.A.
University Hospital, several delayed repairs were made, including convention. The M.Ph.A. provides financial assistance for the ten
the painting of the exterior. Maryland Pharmacy Students who attended the national con-
vention.

This page donated by
District-Paramount
Photo Service.

DISTRICT PROTO int

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

Pictures courtesy Abe Bloom — District Photo

JULY, 1982 23

Lilly Digest

A Preview of 1981 Hospital
Pharmacy Operations

This report includes selected operating data tabu-
lated to reflect a composite profile of the ‘‘average’’
hospital pharmacy in the United States for 1981. Be-
cause this hypothetical pharmacy is derived mathemat-
ically from a broad range of information, the figures
may be too general to use for direct comparison. How-
ever, trends can be determined by comparing the data
with similar figures from the 1980 survey of operations.

The data show that the average hospital had a bed
capacity of 259 in 1981—a 4.4 percent increase from the
previous year and the same bed capacity as that re-
ported in 1979. Census declined from 74 to 73 percent
during 1981. Admissions increased from 8573 to 9212
(an increase of 7.5 percent), which resulted in a shorter
period of patient stay—7.5 days. The largest segment of
reporting hospitals continues to be private (nonprofit)
general institutions.

The number of hours worked by pharmacists and
technicians as well as the hours the central pharmacy
was open rose during the 1981 reporting period. Overall,

2.8 hours of pharmacist time and 2.6 hours of technician
time were required for each hour the central pharmacy
was open during 1981. A comparison of total hours
worked per week by the pharmacy staff in 1981 with
similar data for 1980 reveals that total pharmacy staff
requirements increased somewhat.

The dollar values reported for inventory and pur-
chases were higher during 1981 (up 1.2 and 12.3 percent
respectively). The estimated inventory turnover rate
showed significant growth from 5.3 to 6.1 times. It is
interesting to note that, if the inventory turnover rate
had remained at 5.3 during 1981, inventory costs at
$104,416 would have been over $16,000 higher and
shown an increase of 16.8 percent. That hospital phar-
macy managers exercised control over inventory, as
demonstrated by the improved turnover rate during
1981, is particularly revealing, since last year was one of
continued price increases.

Inventory and purchases on a per-bed basis were
also higher than those reported in last year’s Survey.
However, because the data do not take inflation into
account, it is impossible to determine the extent of its
impact on inventory and purchases figures. Therefore,
the amounts shown do not necessarily reflect expanded
usage of drugs and related items by hospital patients.

Services offered by over 50 percent of hospital
pharmacies responding to the Survey remained un-
changed from the previous year. Monitoring of drug in-

AVERAGE HOSPITAL PHARMACY

Preliminary Report

1981
(1694 hospitals)
Bed capacity 259
Class Private
(nonprofit)

Profile General
Census (beds occupied) 73%
Admissions 9212
Length of patient stay 7.5 days
Hours central pharmacy

open/week 91
Pharmacist hours/week 260 (6.5 F.T.E.)
Technician hours/week 240 (6.0 F.T.E.)
inventory $104,416

$ 1.51/Patient day

$ 403/Bed

$ 552/Occupied bed

$11.33/Admission
Purchases $638,903

$ 9.26/Patient day

$ 2467/Bed

$ 3379/Occupied bed

$69.35/Admission
Inventory turnover rate 6.1 times
Floor area (central pharmacy) 1623 sq ft

Services offered by over 50% of pharmacies
Monitoring patient profiles
Monitoring drug interactions
Providing drug information services
Drug therapy consultation

24

Percent
1980 of
(2152 hospitals) Change
248 + 44%
Private
(nonprofit)
General
74%
8573 + 7.5%
7.8 days
90 é + 1.1%
243 (6.1 F.T.E.) +7 %
231 (5.8 F.T.E.) + 3.9%
$103,211 + 1.2%
$ 1.54/Patient day
$ 416/Bed
$ 562/Occupied bed
$12.04/Admission
$569,045 +12.3%
$ 8.49/Patient day
$ 2294/Bed
$ 3101/Occupied bed
$66.38/Admission
5.3 times
1524 sq ft

Monitoring patient profiles
Monitoring drug interactions
Providing drug information services
Drug therapy consultation

THE MARYLAND PHARMACIST

teractions showed the largest growth rate during the
two-year period 1980-1981, with 87 percent reporting
this service in 1981 as compared with just under 83 per-
cent for 1980, which suggests that hospital pharmacists
are continuing to expand clinical services.

A comparison of selected operating statistics over
the six-year period for which the Lilly Hospital Phar-
macy Survey has been in existence demonstrates the
following trends:

— Pharmacy hours open have risen from 74 to 91 (an
increase of 23 percent).

— Pharmacist hours worked per week have in-
creased 71.1 percent (from 152 to 260 hours).

— Technician hours worked per week have varied
but have increased overall from 129 to 240 (an 86
percent rise).

— Inventory investment has increased 52.1 percent,
and the annual six-year growth rate is 8.7 per-
cent.

— Monies spent on purchases have increased 96.3
percent over the six-year period, with an annual
growth rate of 16.1 percent.

The 1982 edition of the Lilly Hospital Pharmacy
Survey will be distributed in September of this year.

The Center for the Study of
Pharmacy and Therapeutics
for the Elderly

The School of Pharmacy, University of Maryland at
Baltimore, has been instrumental in establishing educa-
tional and service programs in geriatrics/gerontology.

It has done so in recognition of the fact that drugs
constitute a major disease management modality in
long-term care, that elderly receive a disproportionate
number of drugs compared to other population seg-
ments, and that drugs may also constitute a hazard to
elderly if used inappropriately.

Chancellor T. Albert Farmer, M.D., has now ap-
proved, on the recommendation of Dean William J.
Kinnard, Jr., Ph.D., the formation of the Center, which
is a research organization composed of representatives
of all departments of the School. Represented are
Medicinal Chemistry/Pharmacognosy (Dr. Patrick S.
Callery), Pharmacy Practice and Administrative Sci-
ence (Drs. Robert S. Beardsley and Francis B. Palum-
bo), Pharmacology and Toxicology (Dr. Myron Weiner),
Pharmaceutics (Dr. R. Gary Hollenbeck), Pharmaco-
kinetics (Dr. Lawrence J. Lesko) and Clinical Pharmacy
(Dr. Robert J. Michocki). The research center was
formed in response to the realization that a dearth of
good scientific data on the action of drugs, particularly
when they are used chronically, exists and that there

JULY, 1982

is a lack of guidelines for their appropriate use in geriatric
medicine. Some specific goals to be addressed:

e The influence of dosage forms on drug action.
The need for specific dosage forms for elderly
patients.

e@ The interaction of nutrition and drug action.

@ Changing pharmacodynamics and pharmaco-
kinetics with age, and implications of these pro-
cesses to drug therapy.

@ Drug toxicity, adverse drug effects and measures
to prevent or ameliorate their effects.

@ Development of animal models and analytical
methods to study drug action in elderly more ef-
ficiently.

@ Drug-taking behavior of elderly patients.

Drugs used chronically should be able to delay or at
least to diminish the effects of dependency. They must
be used so that they do not impact adversely on the
elderly patient’s mental, functional, nutritional, or
physical status. There is therefore, an overriding neces-
sity to develop the scientific and clinical data base so
necessary to insure better management of drug use for
and by the elderly.

For information, contact Dr. Peter P. Lamy, School
of Pharmacy, University of Maryland, Baltimore, Md.
21201 (301/528-7613).

We have the prescription!

Rx: A Full Service Business Brokerage Firm staffed
with attorneys, accountants, and other profession-
als who specialize in pharmacy and pharmacy-
related businesses. For a confidential appointment
to have an appraisal, valuation, or other service
performed, call

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MARK XXII, LTD.

(301) 657-9727

See also our current listings in the classified ads on page 31.

ed

A Review

by Michael Barletta, Ph.D., R.Ph.
Associate Professor
St. John’s College of Pharmacy

Nifedipine (Procardia®, Pfizer Lab-
oratories) is a member of a new class of
pharmacological agents, the calcium
channel blocking agents, and was ap-
proved by the FDA in December, 1981.
Animal and human studies have shown
that by inhibiting the cellular influx of
calcium ions, nifedipine is a potent cor-
onary and peripheral artery vasodilator.
This effect results in an increase in cor-
onary artery blood flow to normal as
well as ischemic myocardial areas, both
during rest and during exercise. Of spe-
cial therapeutic interest is the high degree
of effectiveness of nifedipine in prevent-
ing coronary artery spasm, which has
been implicated in the etiology of angina
pectoris in many patients. In addition to
the effects of the coronary vasculature,
nifedipine dilates the peripheral arteries,
effectively diminishing the afterload
pressure against which the heart must
work. The net result is a more efficient
ventricular emptying and reduced myo-
cardial oxygen requirements, energy con-
sumption, and work. Therefore, nifedi-
pine manages angina by reducing myo-
cardial oxygen demand while increasing
oxygen supply by preventing spasm.

The pharmacokinetics of nifedipine
have been well described in man. The
drug is rapidly absorbed (90%) after oral
administration with peak blood levels
evident in about 30 minutes. Approxi-
mately thirty percent of the drug is excre-
ted unchanged in the urine, and about 75
percent is excreted in the urine as the me-
tabolite. Nifedipine is 90% bound to
serum proteins with a plasma half-life of
approximately two hours; its therapeutic
effect is evident for a duration of up to
six hours.

In one study of over 100 patients
with Prinzmetal’s (or “ Variant”) angina
who were refractory to conventional ni-
trate and beta-blocker treatment, the
sustained effect of nifedipine (40 to 160
mg/day) was to reduce the number of an-
ginal attacks by 53 percent as well as re-
duce nitroglycerin therapy requirements.

In another well-designed study of
stable angina patients with fixed cor-

26

onary artery disease, nifedipine (30 to
40 mg daily) significantly decreased the
incidence of anginal attacks as well as the
nitroglycerin dosage by SO percent. The
drug also increased exercise tolerance in
these patients and decreased myocardial
oxygen consumption.

A double-blind study, using 16-
point precordial mapping techniques,
showed that a combination of nifedipine
(30 to 60 mg daily) and propranolol had
enhanced antianginal activity.

The adverse reactions of nifedipine
are generally mild. They usually improve
with reduction of other antianginal medi-
cations. Only about 5% of patients have
to be discontinued from the drug. As
with other vasodilators, hypotension can
occur, especially if the patient is concur-
rently taking hypotensive agents. The
following adverse experiences have been
reported: flushing, dizziness, lighthead-
edness, headache and, rarely, syncope.
Peripheral edema, unrelated to conges-
tive failure, which responds favorably to
diuretic treatment, may be a consequence
of vasodilator therapy. Although some
of the other calcium channel blockers
have potentially serious problems in con-
comitant use with beta blockers, only
rare reports of congestive heart failure
with this combination utilizing nifedi-
pine have ever been reported. Nifedipine
may be safely coadministered with ni-
trates; however, no controlled studies are
available which have evaluated the anti-
anginal effectiveness of this combina-
tion. Since there have been teratogenic
effects in animals at high doses and there
are no adequate and well-controlled
studies in pregnant women, nifedipine
should be used during pregnancy only if
the potential benefit justifies the poten-
tial risk to the patient.

Although no well-documented evi-
dence of overdosage exists, as expected
with other potent vasodilators, signifi-
cant hypotension could occur. Such a sit-
uation would warrant cardiovascular
support with vasoconstrictor drug
administration.

Nifedipine should be used with cau-
tion in the patient with severely impaired
liver function, since body clearance may
be prolonged. Because the drug is protein
bound, dialysis may not be beneficial.

The usual starting dose of nifedipine
is 10 mg three times daily with the usual
effective dose range of 10 to 20 mg three
times daily. However, higher doses (20 to
30 mg three or four times daily) may be
necessary to treat patients with coronary
artery spasm. Daily doses as high as 120
mg are rarely necessary, while more than
180 mg per day is not recommended.
Ideally, dose titration should proceed ina
stepwise fashion over a 7- to 14-day
period in order to properly assess the re-
sponse to each dose level and minimize
the likelihood of side effects. Blood pres-
sure monitoring should precede each
higher dose administration. If symptoms
so warrant, and provided that the patient
is assessed frequently, more rapid titra-
tion regimens may be employed, such as
increasing dosage by 10-mg increments
(from 10 mg three times daily to 30 mg
three times daily) over a three-day pe-
riod. Very rapid titration regimens are
possible under close supervision within
the hospital setting. With constant moni-
toring, the dosage can be increased in
10-mg increments over 4- to 6-hour
periods as required to control pain and
arrhythmias due to ischemia, with single
doses rarely exceeding 30 mg. Unlike the
beta blockers, no “rebound” effects have
been observed with abrupt discontinua-
tion of nifedipine. However, sound clini-
cal practice suggests that all drugs be
gradually discontinued.

In conclusion, nifedipine is a new
calcium channel blocking agent which is
approved for use in all types of angina.
Studies show that it is very effective in
chronic stable, vasospastic and mixed
angina (combined spasm and fixed le-
sion). The drug can be employed benefi-
cially together with the conventional
agents used in angina such as nitrates and
propranolol. Side effects are mild and
primarily an extension of vasodilator ac-
tivity. Nifedipine has no known interac-
tion with other drugs and may be safely
administered together with nitrates, beta
blockers, digoxin, furosemide, anti-
coagulants, antihypertensives and anti-
diabetic agents. The drug is unique in
that it represents a new pharmacological
class of agents that is a welcome addition
to the drug therapy of ischemic cardio-
vascular disease.

THE MARYLAND PHARMACIST

William Grove, Past President of the Maryland Society of Hospi- Designated as the AZO Annual Frederick T. Berman Seminar, the
tal Pharmacists represented the Continuing Education Coordinat- program was held at the Quality Inn in Towson Maryland.

ing Council and Chaired the May 2, 1982, Continuing Education
program on ‘Oncology’.

Clarence L. Fortner, Director of Clinical Research Pharmacy Baltimore Metropolitan Pharmaceutical Association President
Service at the Baltimore Cancer Research Program spoke on the Frank Marinelli presided over their meeting held May 19th at the
“Side Effects of Chemotherapy” at this Council sponsored pro- Hilton Hotel in Pikesville. The meeting featured a CECC spon-
gram. sored program, the ‘“‘New Drug Road Show.”’

Jean M. Weis has been assigned to a Baltimore territory for John Moore has recently graduated from a sales training course
The Upjohn Company. She recently completed four weeks of train- for the position of Sales Representative for Burroughs Wellcome
ing at The Upjohn Company Learning Center in Kalamazoo, Company. He will be working out of the Baltimore area.
Michigan.

Pictures courtesy of District-Paramount Photo

JULY, 1982 27

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

ANTIHYPERTENSIVE THERAPY:

A group of 51 hypertensive patients were placed in a
study after their diastolic pressure had been kept below
90 mmHg for a six-month period of time. At that time
there was a reduction in their medication, and the pa-
tients were continually evaluated for 6 more months.
After that initial period, one drug product was elimi-
nated in 38 patients and the dosage of a second drug was
reduced in 49 patients. By the end of a year, 13 patients
required an increase in their medication to maintain
diastolic pressures below 90 mmHg. In general, it is
suggested that drug therapy during hypertension be re-
evaluated periodically in order to reduce the use of un-
necessary medication. J Am Med Assoc, Vol. 246, #22,
ty eels TERE

CEFTIZOXIME:

A new cephalosporin derivative has been found to
be effective against infections caused by some Gram
negative organisms. It is stable to most beta-lactamases
produced by these bacteria and has shown the ability to
eradicate infections caused by the indole positive Pro-
teus, Enterobacter, B. fragilis, and S. marcescens. The
new agent is bacteriocidal and has only minimal toxic-
ity. Ceftizoxime was synthesized in Japan. J Clin
Pharmacol, Vol. 21, #8, 9, p. 388, 1981.

TERBUTALINE:

Terbutaline (Brethine) is a beta-2 adrenergic stimu-
lant used to control symptoms of asthma, but it has also
been utilized to slow uterine contractions and prevent
premature fetal delivery. When used for this purpose,
terbutaline enhances cardiac activity to a significant
extent. Additionally, patients may develop pulmonary
edema. The edema is thought to be associated with in-
creased pulmonary blood flow due to the increased car-
diac activity rather than to cardiac failure. Treatment
for this complication includes withdrawal of the drug,
administration of oxygen, placing the patient in an up-
right position and utilization of small doses (5 to 10 mg
intravenously) of furosemide (Lasix). Symptoms are
generally eliminated within 4 hours after initiation of
this therapy. J Am Med Assoc, Vol. 246, #23, p. 2697,
1981.

MOLINDONE:

Depressed patients refractory to electroconvulsive
therapy and tricyclic antidepressant regimens were
given either tranylcypromine (Parnate) or molindone
(Moban). Molindone in small doses was effective in
treating refractory depression and had a faster onset of
action than the monoamine oxidase inhibitor. Addition-

28

ally, molindone is not associated with as many potential
interactions as is tranyleypromine. J Clin Pharmacol,
VOlE2 a See peo 11981;

METHICILLIN RESISTANT STAPH:

Since 1961 there have been reports of methicillin-
resistant staphylococci appearing throughout the world.
Most of the reports of resistance have been taken from
records of hospitalized patients, but recent information
indicates that these infections are becoming more com-
mon in the general population. The community infec-
tions are thought to have originated in the hospital set-
ting rather than evolving separately. Ann Intern Med,
Vol. 96, #1, p. 11, 1982.

BLEOMYCIN AND LUNG FIBROSIS:

Fibrosis of the lung is a complication of bleomycin
therapy. In order to determine the origin of this prob-
lem, the drug was administered to animals and the prog-
ress of the animals monitored from the biochemical
standpoint. It was noted that bleomycin induced the
lung tissue activity of lysyl oxidase which increased the
concentration of hydroxyproline and desmosine in that
tissue. These substances lead to an increase in connec-
tive tissue rigidity and a reduction in tissue compliance.
J Pharmacol Exp Ther, Vol. 219, #3, p. 675, 1981.

INSULIN-LIKE GROWTH FACTORS:

There are two substances which have been found in
the plasma which contribute to normal growth and de-
velopment, yet have insulin-like activity. One sub-
stance, insulin-like growth factor I (ILGF-1), was found
to be deficient in pygmies and in growth hormone defi-
cient patients. These substances apparently also func-
tion in the regulation of carbohydrate metabolism. N
Engl J Med, Vol. 305, #7, p. 965, 1981.

ANTINEOPLASTIC AGENTS:

People who handle and administer antineoplastic
agents may have an increased risk of toxicity from
these drugs. Pharmacists who prepare solutions of anti-
neoplastic agents were found to have substances in
their urine which could cause abnormal cell growth in
some in-vitro cell systems. The use of masks and rubber
gloves does not seem to help reduce the risk as much as
preparing the solutions carefully under a laminar flow
hood. Prospective studies will be conducted to deter-
mine if those who prepare, administer and handle these
solutions may have an increased risk of toxicity. Addi-
tionally, since many cytotoxic drugs are excreted in the
urine, employees who handle bed pans will also be
studied to see if they too are at risk. J Am Med Assoc,
Vol. 247, #1, p. 11, 1982.

THE MARYLAND PHARMACIST

CIS RETINOIC ACID:

Cis retinoic acid has been used topically and sys-
temically for treatment of various dermatological disor-
ders, yet little is known about its metabolic fate in the
body. Studies conducted in humans indicate that this
congener of vitamin A is metabolized to 4-oxo-13 cis
retinoic acid. Several other minor metabolites have also
been identified. Drug Metab Dispos, Vol. 9, #6, p. 515,
1981.

BOTULINUM TOXIN:

Botulinum toxin is a term used to describe at least
eight separate biological substances. One major toxin
contains two protein chains which function to bind to
tissue and disrupt cellular function. The toxin acts by
preventing acetylcholine release. An extensive review
of Botulinum toxin has just been published. Pharmacol
Revey O12 35.973. po 155,198].

TASTE VARIATION WITH AGE:

Early studies seemed to suggest that the acuity of
taste sensations decrease with age. More complex
studies using solutions of sodium chloride, citric acid,
sucrose, and quinine sulfate indicate that this is true for
sensations which detect saltiness and bitterness, but not
for those which respond to sweetness or sourness. Pa-
tients ranging in age from 23 to 88 years participated in
this study. The reduction in sensitivity to saltiness may
be the reason some elderly patients use the substance in
excessive amounts. J Am Med Assoc, Vol. 247, #6, p.
775, 1982.

ANTACID THERAPY:

Patients receiving antacid therapy and/or cimetidine
(Tagamet) in efforts to reduce gastric acidity may en-
counter an increased risk of Gram negative pneumonia.
Alkalinization of the stomach allows growth of or-
ganisms which will not normally survive the acid pH.
These organisms colonize the stomach during periods of
alkalinity and can gain access to the respiratory tract.
This pneumonia is more common in the severely ill pa-
tient. Lancet, Vol. I., Vol. 8266, p. 242, 1982.

INTRANASAL INSULIN ADMINISTRATION:

Insulin is injected because it is destroyed by enzy-
matic action within the gastrointestinal tract. A group of
investigators in Italy have used the drug intranasally
and have reportedly controlled blood sugar satisfactor-
ily in patients with insulin-dependent diabetes mellitus.
The method is said to be both safe and effective. Br Med
J, Vol. 284, #6312, p. 303, 1982.

OSTEOPOROSIS:

Osteoporosis is most common in post-menopausal
women. Various types of therapy have been used to
help prevent erosion of bone tissue, but recent studies
indicate that perhaps maximal benefit can be obtained
using a combination of calcium, fluoride and estrogenic
substances. N Engl J Med, Vol. 306, #8, p. 446, 1982.

JULY, 1982

ALCOHOL AND PROPOXYPHENE INTERACTION:

Fatal interactions involving propoxyphene (Darvon)
and ethanol constitute the second most common type of
ethanol-associated mortality. Propoxyphene does in-
deed add to the respiratory depression produced by al-
cohol, but another mechanism may also be involved.
Animal experiments indicate that ethanol enhances the
absorption of the analgesic thus suggesting that both
pharmacological and pharmacokinetic parameters may
be associated with this potentiation. Drug Metab Dis-
pos, Vol. 10, #1, p. 92, 1982.

FISH FAT:

Studies conducted in people living in areas where
fish is the major source of food have shown that there is
a lower incidence of atherosclerosis, thrombus forma-
tion and myocardial infarction than is found in other
areas of the world. It has been postulated that an analog
of arachidonic acid, eicosapentaenoic acid (EPA),
found in high concentrations in fish, may be responsible
for producing the beneficial effects. EPA is incorpo-
rated into human platelet lipid membranes in the place
of arachidonic acid thus decreasing the amount of
thromboxane A-2 which can be formed by the platelet.
Since thromboxane A-2 is associated with platelet
aggregation and thrombus formation, reducing its activ-
ity in these areas may help explain the lower incidence
of these cardiovascular complications in patients with
high fish intake. J Am Med Assoc, Vol. 247, #6, p. 729,
1982.

PHENCYCLIDINE:

Phencyclidine (PCP) is a synthetic substance easily
made by amateur chemists with little sophisticated
equipment. Law enforcement officers searching for
suspected manufacturing areas attempt to locate the site
of synthesis by smelling for the solvent used in the
preparation of the hallucinogen. Police officers who
routinely handle confiscated material have been studied
to determine if the substance persists in the body of
people who have come in contact with it. Some officers
were found to have PCP concentrations in their plasma
and urine for at least six months after they had last been
in contact with the chemical. The substance is appar-
ently absorbed through the skin and respiratory tract
and is only slowly eliminated from the body. Clin Tox-
icol, Vol. 18, #9, p. 1015, 1982.

GALL STONE DISSOLUTION:

Patients with cholesterol-rich gallstones may expe-
rience dissolution of the stones while taking cheno-
deoxycholic acid or ursodeoxycholic acid. This therapy
may replace the need for surgery in some patients
and is generally preferred by patients. Sixty pa-
tients who were found to have responded favorably to
this therapy were followed to see if the stones would
reform. Approximately half of the group did exhibit re-
currence of the stones indicating that long-term
follow-up is advisable in order to re-institute therapy if
required. Lancet, Vol. 1, #8265, p. 181, 1982.

29

HCFA Releases Indicators to
Assess Drug Reviews in
Long-term Care Facilities

The Health Standards and Quality Bureau has de-
veloped guidelines to help surveyors determine com-
pliance with drug regimen review requirements in
long-term care facilities.

Medicare and Medicaid regulations require pharma-
cist or nurse conducted drug reviews in skilled nursing
facilities (SNFs), intermediate care facilities (ICFs), and
intermediate care facilities for the mentally retarded
(ICFs/MR). These requirements have been in effect
since 1974.

These reviews entail the examination of a number of
documents (e.g., drug administration records, nursing
notes, physician orders, laboratory reports, etc.). The
information collected from these documents is analyzed
by the pharmacist or nurse to determine if there are any
potential problems with the patient’s drug therapy, and
whether drug therapy is achieving the stated objectives
established by the physician for that patient. If there are
potential problems, and/or if stated objectives are ap-
parently not being achieved, then the attending physi-
cian must be notified for whatever action he or she de-
termines is necessary.

Eleven studies conducted by pharmacists have
demonstrated the cost reduction potential of drug re-
gimen reviews. The potential comes principally from
reductions in drug utilization. For SNF patients this re-
duction could mean a vet annual savings of approxi-
mately $23 million for the Medicare and Medicaid pro-
grams. For ICFs a net annual savings of approximately
$30 million could be realized from these reviews. No
estimates have been calculated for ICFs/MR. These
potential cost savings are exclusive of any that result
from prevention of hospitalizations resulting from poor
drug therapy management. They also do not reflect the
potential for quality improvement.

The Indicators consist of six guidelines that will as-
sist State agency long-term care facility surveyors in
determining whether a quality drug regimen review has
been performed. A summary of the six Indicators is as
follows:

1. The number of drug regimen reviews performed
must be at or near the average census of the fa-
cility in any one month since the regulations re-
quire each patient to be reviewed monthly.

2. Drug regimen reviews should be performed in the
facility.

30

3. The average prescription utilization per patient
should not be significantly over 6.1. The 6.1 av-
erage prescription utilization is the most cur-
rently calculated national average for SNF pa-
tients.

4. Drug administration errors which can be rea-
sonably identified by the reviewer should be
brought to the attention of the director of nursing.

5. Apparent problems in drug therapy such as the
need for drug continuance should be brought to
the attention of the attending physician.

6. The number of drug therapy problems identified
by the pharmacist or nurse should be at least five
per 100 patient months of care rendered.

Those interested in the details of each Indicator are
urged to obtain a complete copy from Dr. Samuel W.
Kidder (FTS 934-1814, or Commercial (301) 594-1814)

If the State agency surveyor finds that a pharmacist
or nurse reviewer has not identified a potential problem
described by the Indicators, and notified someone with
authority to correct the potential problem, then an indi-
cation of poor performance of drug regimen review
exists:

Before these Indicators were recommended for
adoption, they were tested by the Mississippi State Sur-
vey Agency. Eleven health facility surveyors applied
them to 29 SNFs. These surveyors rated the usefulness
of the Indicators at 7.6 on a 10 point scale. In addition a
number of pharmacy, medical, nursing home and con-
sumer groups were consulted before the ‘‘Indicators”’
were adopted.

It must be emphasized that the Indicators are not
regulations. They are merely surveyor guidelines to be
used to determine compliance with the drug regimen
review. A long-term care facility cannot be required to
comply with any component of the Indicators. How-
ever, considerable variance from the Indicators can be a
justification for a non-compliance finding relative to the
drug regimen review requirement.

Implementation of Indicators is expected to result in
better quality drug regimen reviews in long-term care
facilities. Enhancement of drug regimen reviews is ex-
pected to improve the quality of drug therapy and re-
duce its costs. The Indicators were effective on April 1,
1982.

THE MARYLAND PHARMACIST

Classified Ads

Classified ads are a complimentary
service for members.

FOR SALE:

WELL-ESTABLISHED, GROWING PHARMACY in Silver Spring
area. Contact Mitch Baer at MARK XXI, LTD. (301) 657-9727.
ATTRACTIVE, GROWING PHARMACY in Lower P.G. County.
Contact Mitch Baer at MARK XXI, LTD. (301) 657-9727.
PROFESSIONAL PHARMACY in Northern Virginia, grossing
$400K. Contact Mitch Baer at MARK XXI, LTD. (301) 657-9727.
WELL-KEPT PHARMACY in expanding area of Montgomery
County. Contact Mitch Baer at MARK XXI, LTD. (301) 657-9727.
FOR SALE:
Case Register, Sweda-Electric, ten departments, sold with some
supplies. Excellent for 2nd or reserve use. $350.00: Contact
Nathan Schwartz 269-0212.
Professional pharmacy for sale, includes living quarters, very
good opportunity and investment. Call Ed Balcerzak, 433-7572.
FOR SALE:
UNIT DOSE PACKAGING MACHINE. UNIT PAK MODEL XL Il.
(Medical Packaging Inc.) Makes 1,000 sealed and labeled
packages (2 x 2”) in 20 minutes. 90 day warranty on parts & labor.
Reasonably priced. Will train you to use the equipment at no
charge. Larry H. Pozanek, Citizens Pharmacy Services, 415 S.
Market Street, Havre De Grace, Md. 21078 301-939-4404.
POSITION DESIRED
Pharmacist seeking employment in local pharmacy. Please write

or call John J. Selak, 216 Hickory Drive, Fayetteville, Pa. 17222 or
call 717-352-2619.

PHARMACY FOR SALE

Ideal location on corner lot, downtown Bel Air. Modern brick
building, 8474 sq. ft. floor space on two floors. Owner will sell
real estate, business, inventory and equipment. Priced to sell.
Worth looking into. Contact Chas. V. Spalding, Realtor, at 879-2500.

HOTLINE NUMBERS FOR
IMPAIRED PROFESSIONALS
467-4224
796-844 1
685-7878
467-3387

Physicians —
Dentists

Attorneys

Nurses

TEL-MED PROGRAMS IN OPERATION
THROUGHOUT MARYLAND
Prince George’s County
Cheverly
Sacred Heart Hospital
Cumberland
Provident Hospital
Baltimore
University of Maryland Hospital
Baltimore
Memorial Hospital
Easton

345-4080

777-8383

728-2900

528-3111

822-9198

JULY, 1982

PERSONAL MEDICATION RECORD

Prepared by ELDER-ED
University of Maryland School of Pharmacy
636 W. Lombard St. Baltimore, Md. 21201

With a grant from Parke-Davis
Division of Warner-Lambert Company

This Medication Record is available at no charge from either the
Association office or the Elder-Ed Program for distribution to
your patients. Call and order yours now.

CENTENNIAL MARKET

*Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

*Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

* The M.Ph.A. is offering to the public and its members
the USP publication, ‘‘About your Medicine.” This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available—'‘About your
High Blood Pressure Medicine’’—$3.00 each plus $1.00
postage and handling.

*The Pharmacy Art Print “Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

* Centennial Apothecary Jars with the Association’s
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

MARYLAND

PHARMACEUTICA
ASSOCIATION

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

31

SEPARATE BUT EQUALLY
INDISPENSABLE.

—_— cesses

—_-— |
Seer

&

THE 1983 USP DI, NOW IN TWO VOLUMES.

Now more than ever, patients are turning to their drug dosage forms and brands. Volume II is a corres-
pharmacists for advice about drug products. That’s ponding lay language guide for patients with instruc-
why more pharmacists around the country turn to tions on the proper use, precautions and side effects
USP Dispensing Information (USP DI) as the definitive of their medicines.
reference for drug use information. Now the United In addition to the new two-volume DI, USP is
States Pharmacopeia is offering a newly expanded offering the consumer paperback About Your
and updated edition, available for the first time as Medicines and a free kit of advertising and publicity
a two-volume set. tools to help you promote your patient education pro-

Volume I, designed for use by the pharmacist, con- gram. To order your copies, just mail in the coupon
tains detailed dispensing information on over 4,500 below.

Please send me the following: MAIL TO: Maryland Pharmaceutical Association

Quantity 650 W. Lombard Street

1983 USP DI, each complete two-volume set, $37.95. * Botimore Maryiebcarei20)

______ Additional copies of USP D/ Volume II, Advice for the Patient, at $17.95* each.
About Your Medicines Consumer Display Kit (12 lay language paperback books packaged in counter-top display
box), $36.00. (Suggested retail price $4.95.)
1980 USP XX - NFXV, $75.00* *; or $100.00* * with annual supplements.
Free Patient Education Program Promotion Kit.

Total Cost $=. Enclosed is my check or money order for $____ payable to USP, or charge my order to:
OVISA O MASTERCARD AccountNumbe:LI LI OOO OOOUOOOUOOOOO
Expiration Date: Signature:

SEND TO: ADDRESS:

CITY: STATE: ZIP:

“Maryland residents add 5% sales tax. **Pennsylvania residents add 6% sales tax. 1983 USP Dis will be shipped in July 1982.

Wale
MARYLAND
PHARMACIST

Official Journal of
The Maryland
Pharmaceutical
Association

August, 1982
VOEROS
NO. 8

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 ee

AUGUST 1982 VOL? 55 NO. 8

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor
ABRIAN BLOOM, Photographer

CONTENTS

Officers and Board of Trustees

3 President's Message 1982-83
; ; Honorary President
4 President’s Report to the Annual Convention — WILLIAM J. KINNARD JR., Ph.D. — Baltimore
Philip Ree Tecd Dy President
Be eS MILSON SAPPE, P.D. — Baltimore
6 The Need tor leadership» — Vice-President

WILLIAM C. HILL, P.D. — Easton

Treasurer

MELVIN RUBIN, P.D. — Baltimore
12. Annual Report of the Board of Pharmacy — ayes.
Executive Director

Paul Freiman, P.D. DAVID A. BANTA, C.A.E. — Baltimore

Executive Director Emeritus
NATHAN GRUZ, P.D. — Baltimore

William S. Apple, Ph.D.

18 Resolutions

20-21 Centennial Banquet Pictures TRUSTEES
PHILIP H. COGAN, P.D. — Chairman
28 Abstracts Laurel

RONALD SANFORD, P.D. (1985)

Catonsville
JAMES TERBORG, P.D. (1985)
DEPARTMENTS pee
: GEORGE C. VOXAKIS, P.D. (1984)
14 Calendar Balin
a Classified Ads BARBARA BARRON, P.D. (1983)

Rising Sun, Maryland

CHERYL BETZ, SAPhA (1983)
Baltimore

EX-OFFICIO MEMBER

ADVERTISERS WILLIAM J. KINNARD, JR., Ph.D. — Baltimore

26 Abbott 30 Maryland News Distributing

27 ~District Paramount Photo 25 Mayer and Steinberg HOUSE OF DELEGATES

10 The Drug House 11. Parke Davis Speaker

16 Lederle Labs 31 Selby Drug Co. STANTON BROWN, P.D. — Silver Spring
IS Eli Lilly and Co. 29° Upjohn Vice Speaker

17 Loewy Drug Co. HARRY HAMET, P.D. — Baltimore

MARYLAND BOARD OF PHARMACY

Honorary President
Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN, P.D. — Salisbury
new address with zip code number. Allow four weeks for changeover. APhA member —

please include APhA number. President

BERNARD B. LACHMAN, P.D. — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore
part of their annual membership dues. Entered as second class matter at Baltimore, Mary- ANTHONY G. PADUSSIS. P.D. — Timonium

land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201.

PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

2 THE MARYLAND PHARMACIST

President's Message

(These remarks were delivered by President Sappe at the 100th Annual
Banquet of the Association, June 22, 1982.)

I would like to thank the Association members for allowing me to be-
come the first President of our new century; a century of vital concern to all
of us.

Having been connected with pharmacy for most of my years through
working for my dad and later as owner of the pharmacy itself, I have recollec-
tions of the Association as an owner oriented society. This is not true today as
evidenced by the roll of our Association which consists of 205 owners and 819
non-owners. The independent owners are just one of many specialties in our
Association and this is as it should be. The practice of pharmacy is changing. It
might be that in the last 10 years, the delivery of our product or service has
changed more than in the preceeding 90. There are fewer independents, more
chains, third parties, government regulations and intervention, HMO’s,
Pharm.D. programs, clinical, nursing and home care practice. So many things
are changing. I believe the next 19 years will be just as dramatic and will
probably set the stage for pharmacy for many years to come.

It is sad but true that where there exists a highly competitive society, only
the aggressive and the strong remain. Twenty years ago there seemed to be a
small independent pharmacy every few blocks. Many of these have closed
never to open again.

Hopefully the independent pharmacies that now remain open are those
which have withstood the hardening flame of competition and will form a base
whereby independent pharmacy may again grow.

Those of you who are not owners have a different set of problems. In
hospitals where our out-patient departments are being closed because of
financing and those of you who work for the chains where the corporate heads
are looking for higher rates of return, the problem may be loss of jobs or the
possibility of replacement by cheaper technical labor.

It will be here under the umbrella of our State Association that we will be
able to work together in facing our problems and advancing our profession to its
rightful place in the health care delivery system.

The lay public, according to one national poll, already holds pharmacists
next to Godliness. It should now be our goal to maké sure our sister professions
also hold us in the highest esteem.

I am asking all those here to work with me and your Association to make
this goal a reality. Thank you.

Milton Sappe

PRESIDENT

President Milton Sappe (left) accepts the NARD leadership award
from William Hill (right), a member of the Board of Trustees.

AUGUST, 1982 3

MARYLAND
PHARMACEUTICAL
ASSOCIATION

President’s Report
to the

100th Annual Convention

Our Association has accomplished a great deal over
the past twelve months, and | will discuss much of that in
the next few minutes. Our accomplishments for the most
part were a result of our Committee’s activities so at this
time, | commend the unselfish contributions that our
committee members have made. When | was sworn in as
President of the Maryland Pharmaceutical Association,
among other points, | stressed the importance of commit-
tees and their role as a mechanism for Association mem-
bers to affect Association operations. The enthusiastic re-
sponse by our members to serve on committees has been
gratifying. | would like to take the opportunity to thank ev-
eryone who participated on MPhA Committees, especially
the chairmen. We had thirteen standing and ad hoc com-
mittees last year. All of them were active and effective.
Many of them had a banner year in terms of meeting and
exceeding their goals and expectations. In alphabetical
order, | wish to thank our committees for their fine work.

The Awards committee had the unenviable task of rec-
ommending froma list of highly qualified nominees two in-
dividuals to receive our two official MPhA awards, the
Bowl of Hygeia and the MPhA Achievement Award. Joe
Dorsch chaired that committee.

We are all familiar with the fine work of Bill Skinner,
who has chaired the Centennial Committee for two years.
His committee has arranged for a series of events to cele-
brate the one hundredth year since our Association started.
Bill and his committee also developed a variety of com-
memorative paraphernalia and achieved much positive
publicity for pharmacy.

We are here today enjoying the sun of Ocean City, par-
taking in stimulating professional development programs
and deliberating on our future. All this and more was or-
chestrated by Elwin Alpern and the Convention and Trips
Committee. They also arranged for trips to London and
Ireland this year as well as an enjoyable evening to Toby’s
Dinner Theatre in Columbia, Maryland.

Barbara Barron and her committee gave new life to the
old Employee/Employer Relations Committee when they
restructured the committee as a forum and an ombudsman
organization for all pharmacists. They developed an all-
inclusive Model Employment Agreement, conducted a
survey so that we could better understand ourselves and
prepared articles to enhance our professional self-esteem.
They are now preparing a policy manual.

Under the leadership of Nick Lykos, the finance and
Budget Committee formulated a plan for the financial
management of our association, including new sources for
non-dues income. Thanks to the work of many pharmacist,
this Association Is financially healthy and the prognosis for
the future looks even better.

4

to the House of Delegates meeting.

Mark Golibart headed the Industry Relations Commit-
tee. They focus on resolving issues of common concern to
the profession and the drug industry such as improved
legibility of labels and expiration dates, return goods
policies, Desi Drugs labeled less than effective, OTC re-
formulation, look alike drugs, unethical marketing prac-
tices, and improved communications.

Our Legislative Committee under the able leadership of
Milt Sappe did an exemplary job this year. We couldn't do
anything wrong. Practically every bill we opposed was de-
feated and practically every bill we supported, including
repeal of the price poster, was passed.

Another dream come true was the results of our Mem-
bership Committee’s effort. This was a recordbreaking
year for the Association over 1025 new members. Frank
Blatt and his committee worked hard and we are all grate-
ful for their innovative recruitment approaches.

Irv Kamenetz and his Peer Review Committee were able
to equitably resolve to the satisfaction of all concerned
allegations of impropriety by a very small minority of
pharmacists in this state.

Thanks to Harry Fink our Public Relations Committee
chairman and thanks to Phil Weiner who conducted the
weekly public service broadcast on WCAO and WXYV
radio last year, the public’s appreciation of pharmacy is
enhanced. Our press releases concerning our Centennial
Celebration has brought a great deal of favorable recogni-
tion. One year in particular has been the public's en-
thusiastic response to our distribution of the USP publica-
tion, “About your Medicines” drug information for con-
sumers.

THE MARYLAND PHARMACIST

President Cogan and family are shown before the Centennial
Banquet. (left to right) His mother Marie, wife Cookie and daugh-
ter Amy.

The Resolution Committee under the leadership of Jim
TerBorg worked diligently to develop and massage the
language for the resolutions we will consider at this con-
vention.

Dean Leavett chaired the Scholarship Committee. That
Committee screened all the applications for two MPhA
scholarship, the Harry David Kaufman and MPhA schol-
arships and made recommendations for their award.

The Third Party Committee under the leadership of Don
Schumer and Jim TerBorg made great strides this year.
They have maintained dialogue with the State under very
trying and delicate conditions and have suggested several
innovative approaches for public and private third party
reimbursements programs, incentives for cutting costs,
and realistic procedures for those participating in the
Medical Assistance program.

In addition to the regular committees, MPhA holds
seats on two additional committees and rotates as chair-
man every few years. These are the Tripartite Committee,
consisting of the Professional Association, the School of
Pharmacy, MPhA and MSHP. The Tripartite Committee has
been quite successful in resolving issues of common con-
cern to the participating organizations such as dealing
with the PD designation, the pharmacy curriculum and
legislation affecting pharmacy.

The Continuing Education Coordinating Council,
chaired by MPhA. Executive Director Dave Banta this
year, was extremely successful. Every pharmacist in the
State had access to quality continuing education pro-
grams. The traveling ‘‘New Drug Road Shows’ were par-
ticularly well received. Over the years, the Council has
eliminated poorly scheduled, overlapping programs and
has served to bring order to the continuing education pro-
grams sponsored by a variety of pharmacy organizations
in the State.

| would be remiss if | did not mention the pharmacist
who is personally responsible for keeping us all informed
of current events in pharmacy. We all owe a debt of
gratitude to Mel Rubin who has done an excellent job in
writing our newsletter for several years. As many presi-
dents before me, | have also relied upon him for good
advice and counsel. The last person | would like to thank

AUGUST, 1982

and praise is Dave Banta, our Executive Director. | cannot
say enough on his behalf. He is a remarkable adminis-
trator, an excellent journalist, and effective lobbyist and
a delightful individual.

Unfortunately, the news is not one hundred percent
positive. Costs continue to escalate, while third party
reimbursements are not keeping pace with inflation.
Pharmacy still takes a bad rap for the rise in the price of
prescriptions, rules for participation in third party pro-
grams are becoming more cumbersome, crimes against
pharmacies continue unabated and we are over-regulated.

This year we lost a great pharmacist and a great friend.
We will all surely miss pharmacist Victor Morganroth, a
past president, a past honorary president and mentor.

One of the things we wanted to do last year was to
improve communications; | think we have succeeded.
Channels of communications have been opened in every
sphere of our Association's interests. | personally visited
almost every local association at least once. | represented
the Association at the APhA Annual Meeting and | visited
related pharmacy associations in the State. Many other
individuals represented our interests in dialogue with the
State and Federal regulatory agencies, State and Federal
legislatures, other professions, consumer groups and in-
dustry meetings. We have been an active association and
one in which we may all be proud.

Cogan (left) receives the Past Presidents Award from incoming
President Milton Sappe (right).

Jack Peters (right) presents Cogan with the E.R. Squibb Past
President's Award at the annual Banquet.

Special Centennial Address

The Need for LEADERSHIP

by William S. Apple, Ph.D., President
American Pharmaceutical Association

This Centennial Celebration of the founding of the
Maryland Pharmaceutical Association is a source of great
pride to the pharmacists of Maryland and to our profes-
sion. The fact that your Association and many others have
been celebrating the 100th year of their existence is
eloquent testimony of the ‘‘staying power’ not only of the
profession itself but also of the organizations pharmacists
have created to further the broad-based interests of the
profession and to represent it in the community at large.

During the past couple of years, | have had the pleasure
of attending several similar observances among your sister
state associations and of spéaking on many subjects of
current concern to pharmacists and to their national pro-
fessional society, APhA. Let me assure you of my pleasure
in learning—upon receipt of your invitation to address this
Centennial meeting—that my schedule would permit me to
be with you tonight. None of us needs to check our sched-
ules to know we have another commitment at the time the
Bicentennial of the Maryland Pharmaceutical Association
will be noted.

In recent speeches, | have addressed several topics.
Tonight, | want to talk really about only one subject—the
one that | see as being of the most critical importance, at
least insofar as the future of pharmacy as an organized
profession is concerned. My topic is the subject of
“leadership”.

| would be remiss in discussing leadership were | not to
acknowledge the historical fact that the pharmacists of
Maryland have placed an important role in the organiza-
tional life of APhA. William Proctor—known as “The Father
of American Pharmacy’ ’—was born in Baltimore, near the
site of your Association headquarters.

Of APhA’s founders in 1852, three were Marylanders.
No fewer than seven Maryland pharmacists have served as
Presidents of APhA, spanning the years from 1857 through
1940. Among the illustrious Maryland names that have fig-
ured prominently in APhA were George W. Andrews, a
community pharmacist from Baltimore who was elected
Vice-President of APhA at its organizational meeting in
1852 and subsequently served as APhA President in 1857;
Charles Caspari, Jr.,. who was Dean of the Maryland Col-
lege of Pharmacy and who served APhA as its Vice-
President in 1892 and following that, for seventeen years,
served as APhA General Secretary; Evander F. Kelly, who
served as APhA Secretary for almost 20 years from 1925
through 1944; and, of course, Henry A. B. Dunning, who
not only served as APhA President in 1930, but who also
chaired the committee whose efforts resulted in construc-
tion of the present APhA Headquarters building in
Washington in 1932. Among the most influential pharma-
cists in America must be counted Bob Swain who served
as APhA President in 1932 and who was the Editor of Drug
Topics for many years after World War Il.

6

Dr. William S. Apple, President of the American Pharmaceutical
Association delivered a special Centennial Address to the Annual
Banquet. He is shown here with his daughter Chandra before the
start of the Banquet.

APhA was actually headquartered in Baltimore during
the term of Charles Caspari as APhA General Secretary
from 1894 through 1911. So, the ties between APhA and
Maryland pharmacy have been both close and strong.

You will note that in acknowledging the contributions
of Maryland pharmacists to our national professional soci-
ety | have mentioned only several who are no longer with
us but whose legacies to the profession live on. | will not
even attempt to catalog the numerous Maryland pharma-
cists who, happily, are still with us and who have contrib-
uted their time and their efforts to further the goals of
APhA through service on the Association’s many commit-
tees, as Trustees, and as officers during the Association's
modern history.

| also want to acknowledge the foresight of those
Maryland pharmacists who initiated and who have sup-
ported affiliation of your state association with APhA. The
people | could name in these categories—and who are
Known personally to most of you—should well appreciate
what | have to say to you tonight regarding the subject of
leadership, for in my experience they have been true lead-
ers of the profession with all the attributes of leadership
that are to be admired. We need look no further than to
them as role models for the leaders that the profession so
desperately needs today and will need tomorrow.

| have served as the Chief Executive Officer of APhA for
over twenty years. In this post, | have had an excellent
opportunity to observe the development and performance
of the profession’s leadership cadre during that period.
During the first decade of my tenure, | was extremely
gratified at the excitement generated among pharmacists

THE MARYLAND PHARMACIST

and their commitment in not only accepting but seeking
and fulfilling positions of responsibility in the profession's
leadership structure at the national, state, and local or-
ganizational levels. Unfortunately, | now look back and
must say that this healthy situation peaked around ten
years ago, plateaued for a few years, and has since then
been on a downhill trend.

| don't mean to suggest that pharmacy organizations
have had great difficulty in nominating and electing as-
sociation officers, directors, and committee and other ac-
tivity chairmen. | distinguish, however, between holding
such a position and functioning as a leader. Leadership
requires knowledge, imagination, the ability to think, in-
itiative, and unlimited hard work.

The depressing fact is that many pharmacists who have
held organizational positions in recent years served as lit-
tle more than what | call “letterhead leaders’, individuals
whose concept of leadership is limited to seeing their
names printed on their association's letterhead and whose
major goal in organizational life is to collect as many
photographs and press clippings as possible of their ten-
ure in office.

many Pharmacists have served
as little more than ‘‘Letterhead
Leaders’...

It is apparently difficult for some pharmacists to under-
stand that there is a difference between recognition and
leadership. It is my judgment that the profession has suf-
fered a breakdown in its leadership development process,
particularly with regard to bringing along a new genera-
tion of practitioner leaders. Moreover, the failure of posi-
tive leadership influence has been accompanied by an
equally serious phenomenon—a rather virulent increase in
pharmacy political demagoguery. So there will be no mis-
understanding of what | am talking about, let me remind
you that the dictionary characterizes the demagogue as
one ‘‘who makes use of popular prejudices and false
claims and promises to gain power’.

Our failure to develop real leaders in the profession
now combined with a period of severe economic pressures
on community practitioners—particularly pharmacy
owners—once again focuses our attention on an impor-
tant lesson of history. When times are hard, people look for
scapegoats as a preferable course to subjecting their own
behavior to critical analysis and evaluation. Scapegoats
are usually those “‘at the top’.

The past year has seen a recurrence of the old NARD
refrain that APhA does not represent the interests of com-
munity practitioners. In March of this year, the President of
the Indiana Pharmacists Association revived the old chant
that APhA is simply an organization of educators and sci-
entists. He complained on the editorial page of his Associ-
ation’s journal that APhA “is no longer representative of
the pharmacy practitioners of America’. He purportedly
drew his conclusions from the fact that in the last election
for APhA office, there was not a community practitioner
among any of the eight candidates.

In my response, | noted that less than five percent of the
APhA membership is made up of educators and scientists.
| pointed out that this segment of the profession is not only
proud to support and contribute to the profession and
APhA, the Association is also proud to acknowledge their
importance in and to the profession. The fact is that
ninety-five percent of the pharmacists who belong to APhA
are community and hospital pharmacists. Also, during the

AUGUST, 1982

last ten years, seventy-two percent of those elected as
APhA Trustees were either community or hospital prac-
titioners. | also pointed out—and this lies at the heart of my
comments here tonight—that during the two previous
years, 1980 and 1981, not a single pharmacist of any cate-
gory from Indiana had volunteered to be considered for
APhA office. | consider this fact an unfortunate blemish on
an outstanding Hoosier record of contribution to APhA.

For those who may not immediately recall the fact, let
me remind you that APhA members elect the Associaton’s
official family from among pharmacists who submit their
names each year as candidates for APhA elective office.
Those who are nominated are owed nothing by the As-
sociation and they in turn owe APhA nothing but their ded-
icated effort to work for the betterment of the Association
and the profession.

At APhA, we accept at face value the willingness of
volunteers among the membership to make every contri-
bution they can, and we accept their efforts without regard
to the particular area within the profession in which any
individual is employed. | am pleased to note at this meeting
that the Maryland Pharmaceutical Association apparently
shares the same philosophy.

As all of you know, Phil Cogan practices administrative
pharmacy in the federal government. He was elected and
has served as your President this past year because you
recognized his leadership ability as he held one position
after another in your Association. Phil started demon-
strating his leadership potential and commitment to the
profession as a SAPhA leader 20 years ago and has been
contributing ever since. You can be proud of your not
permitting his talent to go to waste.

It is a matter of great concern that some pharmacists
who appear to aspire to recognition will not only resort to
playing political games to gain attention—and sometimes
regard—but also that they are at the same time unwilling to
do the hard work that can lead to recognition based on
merit rather than political strategy and tactics.

There has been a great deal of discussion in our society
of the current quest for instant gratification in social and
work environments. People don’t want to work their way to
the top; they want to be dropped there by helicopter. When
it comes to making a contribution, however, there is no
substitute for experience. A pharmacist who has worked
on behalf of a county association will be a more effective
worker for a state association. And, a person who has
served a meaningful ‘internship’ in a state association's
committee or officer structure will be a more productive
committee member or officer of a national pharmacy or-
ganization.

There simply must be a way to involve in pharmacy
organization work more pharmacists who are willing to
give in order to get. In short, the profession desperately
requires a revival of its past ability to develop pharmacy
leaders with the capacity and willingness to make sub-
stantive contributions to the profession. We need new
people who will be remembered after their service as more
than a name on a letterhead or a face In a picture.

The profession has serious problems to address and it
requires leadership to address them. Let me speak for a
few moments about one of our overriding problems.

It may shock you to learn that | believe the most serious
of our problems are created within the profession itself
rather than among the many stresses and Strains that are
imposed by outside forces. It has been too easy, particu-
larly during the last several years, for pharmacists to lay
the blame for the profession’s difficulties at everyone's
doorstep but their own. But the fact is, my colleagues, we
pharmacists bear a substantial responsibility for having
created and now sustaining our own problems.

Despite the fact that many in pharmacy have a clear
vision of where the profession must proceed in its devel-
opment as a health care calling, and despite the fact that
many individual pharmacists have been doing as much as
they can to futher their role in the health care system and
in serving the public, the bulk of our practitioners simply
have not done enough—in their own interest as well as the
public interest—to take advantage of opportunities to pro-
vide sound professional and economic underpinnings for
their practices. Let me illustrate.

In 1970, APhA commenced its battle on behalf of the
profession to replace fifty state antisubstitution laws with
pharmacist authority to engage in drug product selection.
It is not necessary for me to review in detail the history of
the drug product selection effort. Let me just recall for you
several salient points.

First, APhA sought drug product selection authority for
pharmacists so that pharmacists could function as think-
ing health practitioners rather than as robots in a distribu-
tion cycle.

Second, APhA sought drug product selection for the
economic benefit of self-paying patients and the taxpayers
as well as to improve pharmacy practice economics.

Third, APhA’s position on drug product selection was
initially vigorously opposed by several pharmacy organi-
zations and most pharmacists. By the time pharmacists
recognized the significance of the opportunity and gave
their political support to the required state legislative ef-
forts, consumer and other interest groups had preempted
pharmacy’s leadership role.

If pharmacy had moved swiftly and forcefully in the very
early 1970s, we could have had the onerous antisubstitu-
tion laws repealed instead of replaced. Because we lacked
in quality, quantity, and unity of leadership, the profession
has again been saddled with restrictive and unworkable
bureaucratic procedures. The sad fact is that the American
people now believe that they have restored the pharma-
cists’ privilege and responsibility to be their purchasing
agents for prescription drug products, and the public now
is holding pharmacists accountable for not performing on
their behalf.

While the current situation is not ideal, there is still time
for pharmacists to improve their standing with the public.
It will mean investing time and effort educating both pre-
scribers and patients in who and why they should utilize
the pharmacists’ procurement expertise.

In another area related to economics, | am bitterly dis-
appointed in the failure of practitioners to take advantage
of another opportunity offered by APhA. APhA invested in
the development of the Uniform Cost Accounting System
for pharmacies to improve their economic circumstances
through implementing tighter and more efficient manage-
ment controls. Independent experts in the field have eval-
uated UCAS as an excellent management information tool
capable of being understood and effectively utilized by
pharmacy practitioners. But, the number of pharmacists
who have availed themselves of the opportunity even to
examine UCAS is pitifully small.

Apparently, some practitioners are going to be content
only to expect their associations to wave a magic wand
that will assure their professional success. For such phar-
macists, apparently a good many, the perceived road to
economic salvation is to follow the pied pipers in phar-
macy and their bewitching tales of antitrust law exemp-
tions for collective bargaining, pharmacist unions, and
self-ordained fancy titles.

For those who are inclined to place their hop and bet
their future on the preposterous schemes of some phar-
macy organizations and some individuals in the profes-
sion, | would remind you of the observation offered by the

8

genius of the automobile industry, Henry Ford, to the ef-
fect that ‘A man does not make his reputation on what he
promises.’

Pharmacy is not going to get by on promises. Phar-
macy is not going to get by on self-protective laws and
regulations. And, my colleagues, pharmacy is not going to
get by on naive wishful thinking. There is only one salva-
tion for the profession and its practitioners and that salva-
tion lies in establishing a level of public confidence that
pharmacists are acting both fairly and responsibly in the
public interest as well as their own.

A recent Gallup Poll tells us that, right now, pharma-
cists are held in very high public esteem where questions
of ethics and integrity are involved. What would a similar
poll focusing on pharmacists’ professional competence
and performacne reveal? It is up to each pharmacist on a
one-to-one basis to establish the kind of relationship with
his or her patients that will lead to the overall level of con-
fidence that | am convinced is absolutely necessary for us
to look to future professional and economic rewards. And
to reemphasize my theme regarding the need to develop
new pharmacy leadership, | believe that it is in this most
critical area of professional performance that real leader-
ship in pharmacy is most desperately required.

Pharmacy organizations can provide opportunities, but
only individual practitioners can take advantage of these
opportunities and transform them into such rewards.

... Only one salvation for the pro-
fession ... lies in establishing a level
of public confidence...

Over the years, as | have illustrated, APhA has sought to
provide such opportunities for the profession. Most re-
cently, the Association successfully lead opposition to the
FDA mandatory patient package insert program. Did it do
so because the Association is opposed to patient educa-
tion or because it believes that patients should not have
more information regarding the appropriate and effective
use of drugs dispensed by pharmacists? Anyone who
knows of APhA’s commitment of time and money to pa-
tient education—such as development of the Health Edu-
cation Center Service in the early 1960's would dismiss
such negative motivation out of hand.

No, ladies and gentlemen, the Association's position
and the criticism that it had endured for not going along,
even from respected figures in American pharmacy, was
based on the desire to preserve a professional role for the
pharmacist in patient consultation and education, to pre-
vent the pharmacist from being forced into a role of file
clerk and paper-pusher, and to preserve for the pharmacist
a professional role with both health care and economic
value to the public—a role for which the pharmacist would
ultimately be compensated in recognition of its value.

APhA is not wedded to dogma and its members,
speaking through the Association's House of Delegates,
do not develop its policies out of fear or concern for how
others in or out of pharmacy may react to them. Nonethe-
less, for years the Association has been forced to protect
its flanks and its rear from the incessant sniping of organi-
zational and individual pharmacist demagogues.

After more than thiry-five years in association work, |
am well aware that it is impossible to please everyone with
regard to any given issue—no matter what position or ac-
tion is taken with regard to the matter by any association.
Some members will always disagree with what has been
proposed or done and, frankly, that fact neither surprises

THE MARYLAND PHARMACIST

nor offends me. Nor should it surprise or offend anyone
else in pharmacy. If APhA takes pride in any one of its
achievements, it takes pride in the fact that the Association
operates as a democratic forum in which all voices and
segments of the profession may be heard. After all, dissent
and debate are what democracy is all about.

On the other hand, no one can take pride in the kind of
demagoguery to which | have earlier referred. It should be
exposed and condemned in the strongest terms when it
occurs. Such appeals to prejudice and fear contribute
nothing beneficial to the profession; they damage not just
those attacked but the profession as a whole. Moreover,
such tactics are usually nothing more than a smokescreen
resorted to by those who have no accomplishments of
their own to crow about.

As a result of my long experience in association work,
there are certain truths that | know exist. One of these is
that when old problems are resolved, new problems will
surface to take their place. Another truth is that there has
been and will be no hiatus for the profession when it
comes to opportunities that must be seized. Another truth
is that as pharmacy’s leadership corps and capabilities are
diminished, the difficulty which the profession will experi-
ence in addressing both problems and opportunities will
increase. We simply cannot let that happen.

The American Indian culture admonishes each of us
not to criticize another until we have walked a mile in his
moccasins. | admire that principle, and | urge each of you
and your colleagues to ‘‘walk”’ before you ‘‘talk’’. Do your
walking up front as a leader in the profession whether it is
only in your community or whether it reflects your com-
mitment to assisting your profession at the state or na-
tional level.

And, my colleagues, give an enduring meaning to
your leadership commitment. Reach out to the younger
members of the profession and bring them along with you.
Help them to understand the profession’s need for their
contribution and the value that we place on their involve-
ment in our organizational endeavors. In so doing, you will
write an indelible record of giving to our profession.

The noted journalist Walker Lippman, soon after the
death of Franklin D. Roosevelt, created an epitaph to
which each of us can and should aspire. Lippman said:

“The final test of a leader is that he leaves behind him in
other men the conviction and the will to carry on.”

As individuals and as a profession, | can think of no
finer legacy than that kind of leadership for us to leave
many generations of pharmacists who will step into our
shoes and continue the profession’s march to the future.

The Maryland Pharmaceutical Association can be
proud of everything it has accomplished during the past
hundred years. It will accomplish even more in the next
century of its history if Maryland pharmacists more vigor-
ously pursue the advice they received a third of a century
ago from their own Bob Swain:

“... itis within our power to make tomorrow what we want
it to be, provided we want it hard enough and are willing to
work for it with every resource of heart and mind which we
individually, and as a profession undoubtedly possess.”

Thank you.

CORRECTIONS—In the June issue of the Maryland
Pharmacist we inadvertently published a rough draft

of a letter from Alumni Association President Angelo
Voxakis, instead of his finished letter. We regret the
error and apologize for any inconvenience.

AUGUST, 1982

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The annual LAMPA Brunch experienced an unusually high
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100th Convention

ANNUAL REPORT
OF THE
MARYLAND BOARD OF PHARMACY
1981-1982

In compliance with the provisions as set forth in the
Health Occupations Article Section 12-205 of the
Annotated Code of Maryland, this report is submitted to
the Honorable Harry Hughes, Governor of Maryland and to
the Maryland Pharmaceutical Association. This is the
seventy-nineth report to the Governor and the sixth-nineth
report to the Association. The report covers the activities
of the Maryland Board of Pharmacy for the fiscal year
ending June 30, 1982. This report is also being submitted to
the Secretary of Health and Mental Hygiene, the McKeldin
Library of the University of Maryland, the Enoch Pratt Free
Library, the Department of Legislative Reference, the Hall
of Records, and the State Library.

MEETINGS

During the year the Board held nineteen meetings,
seven of which were held at the School of Pharmacy of the
University of Maryland, for the purpose of conducting
examinations for registration of pharmacists.

OFFICERS

Bernard Lachman was elected President and Paul
Freiman was elected Secretary-Treasurer of the Board.

PERSONNEL

Roslyn Scheer is the Administrator, Margaret Lloyd
is the Office-Clerk | and Sandra Kimble-El is the Steno
Clerk Ill.

EXAMINATION

The Board conducted examinations for registration of
pharmacists during the fiscal year. They were held at the
School of Pharmacy of the University of Maryland on June
23, 24, 25, and 26, 1981 and January 26, 27, and 28, 1982.

The applicants who were examined in June of 1981
were licensed in July 1981 which is in F.Y. 1982. There
were one hundred and thirteen applicants for the Board in
June, 1981. Eighty-six passed both the theoretical and
practical portions of the examination and were sub-
sequently registered. Twenty-four failed the examination.
Having previously passed the practical portion of the
examination, three candidates took the theoretical exami-
nation in June. The candidates passed and were sub-
sequently registered.

There were twenty-five applicants for the Board in
January, 1982 (F.Y. 82). Nine passed both the theoretical
and practical portions of the examination and were sub-
sequently registered. Twelve failed the examination. Hav-
ing previously passed portions of the examination, four
candidates took the practical examination, passed and
were subsequently registered.

Data relative to the June 1982 examination will be given
in the next Annual Report.

The Standard Examination of the National Association
of Boards of Pharmacy was given, which consisted of the

12

following subjects:

Chemistry

Pharmacy
Mathematics
Pharmacology
Practice of Pharmacy
Laboratory
Jurisprudence

The Jurisprudence examination included the Federal
Law Exam and the Maryland Law Exam. The Maryland Law
Exam was compiled by a member of the Board and was
given as a part of the practical portion of the examination,
as well as the compounding of three prescriptions per
applicant. The following table shows the number of phar-
macists who were registered by examination during the
past ten years:

Number of
Year Pharmacists
1921973 96
1973-1974 Wah
1974-1975 Wine
1975-1976 109
1976-1977 166
1977-1978 150
1979-1980 180
1980-1981 183
1981-1982 100

As in the past, many pharmacists applied for reciprocal
registration in Maryland in order to accept positions with
their employers who are opening stores in Maryland.
Those applicants who did not meet our requirements con-
cerning practical experience prior to or after registration
in another state were advised that they must take our
practical examination in order to verify their qualifications.

In all cases an applicant for reciprocal registration
must appear for a personal interview. The entire Board
must act on whether or not to grant registration to such
applicants, who must sign an agreement to comply with
Maryland’s law pertaining to drugs and pharmacy.

The following table shows the number of pharmacists
granted registration by reciprocity and the number who
were certified to register by reciprocity in other states
during the past ten years.

Fiscal Year Reciprocity Certification
1972=1973 94 SV
1973-1974 88 63
1974-1975 76 45
1975-1976 89 44
19761977 78 68
1977-1978 91 a
19% Get 379 113 42
1979-1980 73 69
1980-1981 88 72
1981-1982 85 om
Total

THE MARYLAND PHARMACIST

Paul Freiman, Secretary of the Maryland Board of Pharmacy de-

livers the annual report to the Maryland Pharmaceutical Associa-
tion House of Delegates as specified by law.

The table shows Maryland gained 34 pharmacists by
reciprocity during the past ten years.

New permits to operate a pharmacy were issued to 44
firms for the 1982 Fiscal Year.

PHARMACY PERMITS

Location 1981-1982
Counties:
Anne Arundel
Baltimore
Carroll
Charles
Garrett
Harford
Kent
Montgomery
Prince Georges
County Totals
Baltimore City

State-Wide Totals

w a
AfRWNMNWANMAOW

Bay
t

MANUFACTURERS’ PERMITS

New permits to manufacture drugs, medicines, toilet
articles, dentrifices, or cosmetics during 1981 were issued
to one firm.

DANGEROUS DRUG DISTRIBUTORS’ PERMITS

The Board issued four new permits to sell, distribute,
give or in any way dispose of dangerous drugs during
1981.

OTHER PERMITS

The total number of pharmacies in the State of Mary-
land for 1982 fiscal year is 918 and the total number of
pharmacists in 5,060.

LEGISLATION

The following legislation which effects the profession
of pharmacy either directly or indirectly was enacted by
the 1982 Maryland General Assembly.

List of Bills that were enacted during the 1981 Legisla-
tive Session and their purpose as it pertains to pharmacy.

New Laws Effective July 1, 1982

SB 280 - Pharmacists - Licenses - For - License Renewal -
Reinstatement of Expired Licenses—
Changes examination fee to $85 (actual cost of exami-
nation). Allows Board to renew pharmacist licenses in
both odd and even numbered years. Allows the Board to
adopt rules and regulations governing reinstatement of
pharmacists licenses.

AUGUST, 1982

HB201 - Drug Formulary of Equivalent Drug Products—
Provides for the automatic listing in Maryland's Drug
Formulary of all drugs that meet FDA’s standards for
approval as safe, effective and determined to be
therapeutically equivalent.

HB423 - Board of Pharmacy Licenses—
Allows the Board to adopt rules and regulations gov-
erning reinstatement of pharmacists’ licenses and to set
a reinstatement fee.

HB642 - Health Occupation Boards and Commissions -

Licenses, Permit, and Certification Renewal Fees—
Standardized the renewal fees for all Boards within the
Health Department. Fees for pharmacist license, phar-
macy permit, manufacturer permit and distributors
permit are equivalent to $25 a year.

HB1170 - Prescription Drugs - Required Information—
Prescription price posters are no longer required in
pharmacies. Instead the pharmacist is required to pro-
vide the current price of any prescription to the cus-
tomer in person or by telephone.

DISCIPLINARY ACTIVITIES

The Board of Pharmacy receives complaints from the
public concerning problems with the Board's licenses. For
the period of April 1981 to April of 1982 complaints were
received. There was a wide range of complaints which
varied in severity. Listed below are statistics concerning
the types of consumer complaints.

miscellaneous—3rd party complaints 114
miscellaneous” 26
mislabeled prescription 9
communication 11
incorrect drug dispensed 18
homeopattrie pharmacy 1
expiration date 7
generic substitution 5
refilling prescription without authorization 2
infrequently prescribed drug—hard to find 2

“Complaints are on pricing, cleanliness, professionalism—
such as pharmacist feeling prescription is a forgery but refuses to
check with physician, refusal to transfer prescriptions legal drugs

Other complaints were received from the Division of
Drug Control, Medical Assistance Compliance Adminis-
tration, and the State of Maryland Courts. Six formal disci-
plinary hearings were held. Four pharmacists licenses
were suspended. Two pharmacists’ licenses were revoked.
Three of the suspensions were immediately stayed and the
individuals placed on probation under certain conditions.

COOPERATIVE ACTIVITIES

The Board maintained membership in the National As-
sociation of Boards of Pharmacy. The annual meeting of
the Association was held in Minneapolis, Minnesota on
May 17th—May 20th 1982. The Board was represented by
Drs. Bernard Lachman, Paul Freiman, Leonard DeMino,
and Robert E. Snyder.

The Board also maintained membership in the Confer-
ence of Boards and Colleges of Pharmacy of the National
Association of Boards of Pharmacy, District Number Two,
comprised of the states of New York, New Jersey, PennsyI-
vania, Delaware, Maryland, the District of Columbia, Vir-
ginia and West Virginia.

The Board maintained cooperative activities with the
State Department of Health and Mental Hygiene, the
School of Pharmacy—University of Maryland, the Mary-
land Pharmaceutical Association, the Federal Drug Ad-
ministration, the Food and Drug Administration, City,
County and State Police and all Boards and Pharmacy
Schools throughout the country.

13

FINANCES

All funds of the Board of Pharmacy are deposited to the
credit of the Treasurer of the State of Maryland and the
disbursements covering the expenses of the Board are
paid by voucher by the State Comptroller.

FINANCIAL STATEMENT

The Board of Pharmacy had revenues of $31,120 in
1980 and $97,671 in 1981. The Board of Pharmacy had
expenditures of $52,020 in 1980 and $71,992 in 1981. The
Board’s budget is $63,749 for 1982 and $76,235 for 1983.
Due to the passage of HB642, the Department of Health
and Mental Hygiene has proposed a supplemental budget
for 1983 of $32,092. Total budget $108,327—which will in-
clude a full time administrator and another secretary.

OTHER ACTIVITIES

In addition to the President Bernard Lachman and Sec-
retary Paul Freiman, the Board consists of the following
commissioners: Ralph Quarles, Robert Snyder, Leonard
DeMino, Anthony Padussis, Estelle Cohne, and Phyllis
Trump. All the Commissioners are registered pharmacists
in the State of Maryland with the exception of Ms. Cohen
and Ms. Trump who are consumer (public) members of the
Board. Since the last Annual Report, the Board promul-
gated the following regulations:

1. Regulation to prevent returning to pharmacist’s
stock any medication once it is dispensed except
under certain conditions;

2. Regulation requiring every prescription to be re-
corded with date of filling or refilling and pharmacist
responsible for filling or refilling prescription; and

3. Regulation setting reciprocity fee at $100.

At this time the Board has submitted the following reg-
ulations:

1. Regulation to set degree of fines upon disciplinary

action of Board of Pharmacy;

2. Regulation to declare undated prescription items on
pharmacy shelves to be declared outdated and
subject to removal.

In 1982, the Board continued its excellent relationships
with the Department of Health and Mental Hygiene. The
cooperation and courtesy extended to the Board of Phar-
macy by all members of the Department is appreciated by
all the Board members.

This year saw the finalization of the transfer of Division
of Drug Control to Regulatory Services. Dr. Tregoe has
developed a mechanism of operation that the Board be-
lieves will assure the public of Maryland greater safety and
protection in the use of their medication wherever it is
purchased or dispensed. The Board will monitor the new
operation to assure its success in meeting this goal.

Again the Board must commend our administrator,
Roslyn Scheer for her continued excellent management of
the Board's daily business. Through her efforts the Board
continues to operate smoothly and efficiently. In addition,
the Secretary must commend both of our excellent sec-
retaries Sandra Kimbel-El and Margaret Lloyd for their
excellent work and cooperation.

In addition to the items as stated, the Board partici-
pated in many activities too numerous to mention. All of the
Commissioners actively participated by serving on various
committees appointed by the President, attending numer-
ous meetings throughout the State, and being available for
consultations and special meetings when necessary.

Respectfully submitted,
Paul Freiman
Secretary-Treasurer

l4

Congratulations from
MSHP

On behalf of the members and the Board of Directors of
the Maryland Society of Hospital Pharmacists, | extend
congratulations on your 100th Anniversary of the founding
of the Maryland Pharmaceutical Association. The efforts
you have made to mark this occasion, culminating a cen-
tury of dedication to the profession and to the patients to
whom you serve, deserve special recognition, and you are
to be congratulated.

This legacy of growth and dedication to the profession
has also created a challenge and a responsibility to you, as
you begin your second century; a challenge to respond to
the forces which influence the profession, and a responsi-
bility to respond in such a manner that delegates to the
200th Annual Meeting of the Maryland Pharmaceutical As-
sociation will be able to look back at 1982 and recognize
that not only was a chronologic milestone reached, but
also a professional one. As you take your first steps into
your new century, do so with the realization that the future
of pharmacy depends on the directions that you take
today.

As | complete my term of office as President of the
Maryland Society of Hospital Pharmacists, | look back
over the year at the degree of communication and cooper-
ation which occurred between the Society and the Associa-
tion as a highlight of my term, particularly in the joint ef-
forts on behalf of the Continuing Education Coordinating
Council. | look forward to continued joint efforts between
the MSHP and MPhA in such matters as continuing edu-
cation, legislation and other matters of professional con-
cern.

Again, the Maryland Society of Hospital Pharmacists
congratulates you on this special occasion, and looks for-
ward to having you share in the celebration of our 100th
Anniversary (in 2044!).

Sincerely,
William R. Grove, M.S.
President

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THE MARYLAND PHARMACIST

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Divisions of

Resolutions Considered at the
100th Annual Convention House
of Delegates Meeting

1982 RESOLUTION #1

WHEREAS, the name of the Maryland Pharmaceutical As-
sociation has often been misleading to those not familiar
with the state professional society of pharmacists because
the name ‘Pharmaceutical’ has been confused with man-
ufacturing, wholesaling or other outside interest; and
WHEREAS, the Maryland Pharmaceutical Association is
beginning a second century of service to pharmacists and
the public health and it is appropriate to clearly define the
nature and identity of this organization;

THEREFORE BE IT RESOLVED, that the name of the
Maryland Pharmaceutical Association be changed to the
‘Maryland Pharmacists Association’’ as we begin our next
one hundred years; and

BE IT FURTHER RESOLVED, that consistent with the pru-
dent use of existing supplies, that this changeover to the
new name be conducted as expeditiously as possible.

(Resolution Defeated)

1982 RESOLUTION #2

WHEREAS, the Maryland Pharmaceutical is concerned
that mentally or physically impaired pharmacists receive
professional assistance and be prevented from posing a
hazzard to the public health; and

WHEREAS, the Association is in a good position to provide
peer support and coordination of activities with regard to
alcoholic or drug dependent pharmacists;

THEREFORE BE IT RESOLVED, that the Association form
a “Rehabilitation Committee” to study methods for detec-
tion, counseling and support services for chemically im-
paired pharmacists.

(Resolution Adopted)

1982 RESOLUTION #3

WHEREAS, the Centennial of the Maryland Pharmaceu-
tical Association is a special event of historic signifi-
cance; and

WHEREAS, the Maryland Historical Society is the reposi-
tory of many of the historical documents and artifacts of
the State of Maryland;

BE IT RESOLVED, that the list of registrants at the 100th
Annual Meeting, a list of the membership, and other ap-
propriate materials, be placed with the Maryland Historical
Society.

(Resolution Adopted)

18

1982 RESOLUTION #4

WHEREAS, the U.S.P. has evolved into a compendia of
high utility to the pharmaceutical industry but of reduced
utility to the practicing pharmacists; and

WHEREAS, the U.S.P. Dispensing Information has been
developed as a resource for practicing pharmacist;

BE IT RESOLVED, that the Maryland Pharmaceutical As-
sociation would support a change in the pharmacy law to
repeal the requirement of having A U.S.P. in every licensed
pharmacy and replace it with a requirement that every
pharmacy have a current edition of the U.S.P. Dispensing
Information.

(Referred back to the Board of Trustees for study)

1982 RESOLUTION #5

WHEREAS, the armed robbery of Pharmacies is a major
threat to the lives of practicing pharmacists; and
WHEREAS, there are before the Congress several bills ad-
dressing the problem of armed robberies of controlled
substances which should have as much grass roots sup-
port as possible; and

WHEREAS, the Maryland Pharmaceutical Association is
strongly convinced that mandatory sentencing would be a
strong deterrent to such crime;

THEREFORE BE IT RESOLVED, that the Maryland Phar-
maceutical Association urges mandatory sentences for
persons convicted of armed robbery involving controlled
substances.

(Resolution Adopted)

1982 RESOLUTION #6

WHEREAS, the Surgeon General has determined that
smoking is hazardous to your health; and

WHEREAS, the Pharmacy profession is committed to the
general health and well-being of their patients;

BE IT RESOLVED, that the Maryland Pharmaceutical As-
sociation urge their members to refrain from selling to-
bacco products in their pharmacies and make available
educational materials on the hazards of smoking.

(Resolution Defeated)

1982 RESOLUTION 7

WHEREAS, the Maryland Pharmaceutical Association and
the University of Maryland School of Pharmacy have en-
joyed a long and fruitful Association; and

THE MARYLAND PHARMACIST

WHEREAS, the Maryland Pharmaceutical Association is
celebrating its Centennial Celebration; and

WHEREAS, the Maryland School of Pharmacy is celebrat-
ing the opening of their new building;

BE IT RESOLVED, that the Board of Trustees of The As-
sociation investigate the commissioning of an appropriate
plaque or other contribution to the School commemorat-
ing these two unique celebrations.

(Resolution Adopted)

1982 RESOLUTION
(Proposed from the floor)

WHEREAS, the continuing spiraling cost of medication is a
growing concern to the profession of Pharmacy;
WHEREAS, pharmacists have been placed in the forefront
of the blame for these increases, even though they have no
control over them at all; and

WHEREAS, one 3rd party program has decided to restrict
freedom of choice using as an excuse, the refusal of
pharmacists to use generic drugs, thus choosing to ignore
the real causes of this inflationary spiral;

NOW, THEREFORE BE IT RESOLVED, that the Maryland
Pharmaceutical Association immediately convene a con-
ference of all those involved in the distribution and pay-
ment for medication. This conference should include rep-
resentatives from 3rd party providers, other health profes-
sion organizations, and manufacturers, so that effective
action may be taken by all concerned to help alleviate this
situation, and also be it resolved that the press be invited
to attend the conference, and notified of our concern and
the efforts of this association and its members to meet that
concern.

Respectfully submitted,
Paul Freiman, P.D.
(Resolution Adopted)

A MOTION PROPOSED FROM THE FLOOR

| MOVE THAT the Association create a Memorial honoring
the outstanding dedication, support and guidance to this
Association and its members from Victor Morgenroth, Jr.;
ALSO | MOVE THAT a letter be sent to his widow express-
ing our condolences at his loss.

Respectfully submitted,
S. Ben Friedman, P.D.

(Motion Passed)

a a.‘ ' "Oe { . |
James TerBorg delivers the report of the Third Party Committee
and the Resolutions Committee.

AUGUST, 1982

MPhA’s Third Party Committee
Report to House of Delegates

On December 10, 1980 then Chairman Doctor Don
Schumer called a meeting of the Maryland Pharmaceutical
Associations Third Party Committee. At the time the
“Georgia Bill’ was before the Maryland legislature, the
PharmPAC suit had just been dismissed by the federal
court and an upcoming survey of pharmacy dispensing
costs was coming from the state medicaid program. Issues
of great concern all to even the most apathetic of pharma-
cists. Indeed these subjects were the motivation for all who
attended the meeting. The decision to not refile the suit,
the completion of the survey and the need for further study
of the ‘‘Georgia Bill’ settled these issues over the course
of the following months. | accepted the co-chairmanship
of this committee because | shared with you a feeling of
righteous indignation towards third party administrators
and their dealings with us. | also realized that change in
this area would be a slow process. Although my indigna-
tion remains at a healthy level, accepting the sobering re-
ality of the time consumed in bringing about change has
been a real challenge.

It was the stated objective of the committee to relieve
the Board of Trustees of the task of initiating efforts in
third party related matters by submitting specific propos-
als for approval then following through. The committee
was to serve as a Structure for dealing with ongoing prob-
lems as well as acting as a ‘crisis intervention team’ if the
need arose. The committee would also serve as a com-
munications center for members with questions or prob-
lems related to third parties. The committee did serve as
intended on the first two points but made little headway
establishing itself as a third party communications center.
No members, in fact, actually requested such service for
whatever reason.

It would please the committee to announce model
contracts with all third party plans including the accep-
tance of usual and customary charges. There are other
illusions the committee would be happy to report but, alas,
they remain just that—illusions. Our accomplishments are
in terms of steps not in finished products. The state will
give us this July a thirty cent increase in the medical as-
sistance fee bringing to a total of a dollar in increases
since the last fee survey was taken. This has come about in
no small part because of the untiring efforts of Dave Banta,
Doctors Schumer, Rubin and others who continuously
meet with state officials to present pharmacy’s case. The
initiative of Dr. Bookoff in offering an incentive program
and Dr’s. Sanford and Schumer offering a manufacturer's
rebate program to medical assistance typifies the basic
give and take (mostly give) that is the cornerstone of our
dealing with third parties. If successful at the state level the
committee will be going to private plans with similar
suggestions—ones very fair to pharmacists and offering
substantial savings to the plans. Only time and continued
diligent effort will tell. Would you like to know more details
about any of the above mentioned projects? Call us at
727-0746 or catch us at Ocean City.

My personal thanks to Doctors Brown, Lichtman,
Zucker, Powell and Leo as well as those mentioned above
for their participation this past year.

Thank you,
James Louis TerBorg, P.D.
Don Schumer, P.D.

19

Centenni

The Officers and Trustees of the Association are shown shortly
after installation. They are: (left to right) Philip Cogan, Chairman
of the Board; William J. Kinnard Jr., Honorary President; William
Hill, Vice President; David Banta, Executive Director; Melvin
Rubin, Treasurer; George Voxakis, Trustee; Barbara Barron,
Trustee; Milton Sappe, President (and captain of the ship); Ronald
Sanford, Trustee; James TerBorg, Trustee; Cheryl Betz, SAPhA;
Stanton Brown, Speaker of the House; Harry Hamet, Vice Speaker
of the House and Charles Spigelmire, the Installing Officer.

Morris Cooper (left) was this year’s recipient of the M.Ph.A. Dis-
tinguished Achievement Award for his contributions in maintain-
ing the B. Olive Cole Pharmacy Museum in the Kelly Building as

George Voxakis served as Toastmaster for the Centennial Ban- its Curator. Cogan presents the Award.
quet.

Mike Hickey from the Kerr Glass Company (left) presents Presi- Mark Golibart (left) representing Abbott Labs, and also Chairman
dent Cogan with a special Award on the Occasion of the Centen- of the Association's Industry Relations Committee, presents
nial Celebration. President Cogan with his Company's Award for the Centennial.

20 THE MARYLAND PHARMACIST

All Convention Pictures Courtesy of
District/Paramount Photo

Sam Goldstein (right) receives this year’s Bowl of Hygeia Award
for his community service work with the Elder Ed Program and
other activities from A. H. Robins Company representative Ray
Langston.

The 1982/83 Honorary President William J. Kinnard, Jr., Dean of

the School of Pharmacy, receives his award from President Cogan
at Annual Banquet.

“Raining on his Parade.’ Ronald Sanford got wet when the air-
conditioner above the podium sprung a leak in the middle of his
report. House of Delegates Parlimentarian Donald Fedder at-
tempts to help out (right).

Frank X. Radigan from Merck, Sharp and Dhome presents his
Richard Plotkin, representing the Geigy Co. presents Cookie Company's Award to the President Cogan on the occasion of the
Cogan with the ‘Pharmacists Mate’’ Award. Centennial Celebration.

AUGUST, 1982 21

Employer/Employee Relations
Forum Report

The Employer/Employee Relations Committee was
reactivated this year after several years of inactivity.

The first act of the committee was to change the name
from the Employer/Employee Relations Committee to the
Employer/Employee Relations Forum so as to better rep-
resent the role of this group.

The first task undertaken by the Forum was to compile
a Model Employment Agreement that was later published
in the journal. This document was felt to be of great value
to both employers and employees and offered many
suggestions for consideration of employment.

The most important assignment was to complete a
document urging the use, in all pharmacies, of a Policy
Manual, and to compile suggested topics that should be
covered in an effort to establish a guideline for pharma-
cists in this state wishing to implement a policy manual.

This group has been very active throughout this year,
and its members have met regularly. | would like to take
this opportunity to thank all the members of this Forum
and the Executive Secretary of the Maryland Pharmaceuti-
cal Association for their dedicated efforts and hard work.
Much has been accomplished this year, but there is also
much left to be completed.

Barbara C. Barron
Chairman

Industry Relations
Committee Report

First | want to thank all of the Committee members who
took time from their practices and busy schedules to serve
with me on this Committee. | feel we accomplished a lot.
The Committee continued projects related to return goods
policies of manufacturers. The model policy adopted by
the Committee and the Association was published in the
Maryland Pharmacist. The Committee surveyed manufac-
turers for a list of their representatives in Maryland, a list of
toll-free numbers available to pharmacists and a copy of
their return goods policies.

The Committee collected samples of unreadable expi-
ration dates which were forwarded to the A.Ph.A. for their
meeting with the OTC manufacturers. The subject of un-
readable expiration dates was suggested by the Commit-
tee for that meeting. The Committee was concerned about
OTC reformulation without notice to the Pharmacist. A
survey was conducted of OTC manufacturers and the re-
sults published in the Maryland Pharmacist. The Commit-
tee also published the Manufacturer Disclosure List which
appeared in California for the information of the members.
The Committee met with a clinical pharmacist to discuss
new ways that pharmacists and manufacturers can com-
municate with one another as the practice of pharmacy
evolves.

Most recently, the Committee has discussed the rising
cost of drug products. We anticipate that this subject will
be one of our main focuses as we move into the second
century.

Mark Golibart
Chairman

bo
bo

Bin

wii,

Barbara Barron, Chairman of the Employer/Employee Relations
Forum, delivers her Committee’s Report to the House.

a

Peer Review Committee Report

The Peer Review Committee is alive and well!!! Over the
past year it haS continued its main function; that is, to
investigate and answer any complaints about pharmacy
and pharmacists. Most letters reflected the public confi-
dence in pharmacists; they were astounded that a phar-
macist could make an error in dispensing medication.
When there was a miscount in the number of tablets dis-
pensed, the complaintant assumed it was a deliberate
policy of the chain drug store.

We had an unusual complaint this year ... one phar-
macist complaining about the action of another pharma-
cist. A competitor was accused of mislabeling a prescrip-
tion with the brand name instead of the generic name,
thereby getting an economic advantage. We settled amic-
ably, the way disputes between pharmacists should be
settled. We would like the Peer review Committee to con-
tinue being a forum to settle such intra-pharmacist dis-
putes.

It is most important that the Peer Review Committee
continue to answer promptly any letter of complaint di-
rected to the Maryland Pharmaceutical Association.

Irvin Kamenetz, P.D.
Chairman

Irvin Kamenetz, Chairman of the Peer Review Committee, an-
swered many questions regarding the work of the Committee over
the past year. Watch for more detailed reports in future issues of
the Maryland Pharmacist.

THE MARYLAND PHARMACIST

Centennial Celebration
Committee Report

It is my pleasure, on behalf of each member and helper
to this Committee, to tell you that most of our plans are on
schedule, during this, our Centennial year—1982. Those
plans were finalized during the last annual meeting and
subsequently presented to your officers and Board for re-
view.

Let me just review for you what we have done in 1982
and what we have to do during the remainder of the year.
But let me preface these remarks to explain that your
Committee decided to direct most of its Centennial ener-
gies toward getting each of you involved in the celebra-
tion. We decided not to purchase a lot of souvenirs and
trinkets, only a few to give each pharmacist the opportu-
nity to have a memento to help share the memories. We
decided to emphasize the past accomplishments of Mary-
land pharmacists through articles in the Maryland Phar-
macist and not by elaborate books that might put us in
debt.

We decided to use 1982 to launch greater efforts to tell
the general public of Maryland what it is we can do for
health care during the next 100 years and you will be
hearing more about this later.

During 1982, we have thus far kicked off our celebra-
tion by recognition from the Baltimore Metropolitan
Pharmaceutical Association at its February Dinner-Dance.
BMPA President Frank Marinelli presented a recognition
plaque to MPhA President Philip Cogan and your chair-
man sketched the 100 years of history of service to the
public health as a solid foundation upon which to build
and a heritage which we must constantly live up to.

Following the kickoff event, we have focused attention
on the centennial at the Spring Regional Meeting as we
will at each of the upcoming state events throughout the
year. During the Spring Regional Meeting Issues Forum,
we dedicated a new sign on the lawn of the Kelly Memorial
Building to announce the visiting policy of the Olive Cole
Pharmacy Museum. Thanks to Executive Director David
Banta, all of the necessary clearances were obtained from
the University and the sign was ordered and placed. David
tells me that our sign has evoked only favorable response
from the association’s neighbors and it has led to a
number of inquiries about the museum.

Further, we dedicated a plaque to the memory of two of
our towering pharmacy fathers who made an impact on
our profession. The plaque can be seen in the association
office now, but will soon be properly placed in the museum
to acknowledge our gratefulness to Dr. David Stewart and
Dr. William Proctor.

Stewart—a pharmacist, physician, educator, school
board member, a state senator, city councilman and
scientist—gave Maryland Pharmacists an enormous
example and model to pattern their careers upon. If our
profession only had ten more leaders like Stewart today,
we would probably be taking more active roles in at-
tempting to solve our problems now facing us.

Proctor, a native of Baltimore, became an apprentice
apothecary and learned the profession in Philadelphia, he
later became the professor of pharmacy at the Philadel-
phia College of Pharmacy, editor of journals, leader in the
American Pharmaceutical Association and the beloved,
respected and venerated stateman of the profession who
was dubbed ‘‘The Father of American Pharmacy” by his
contemporaries. Naturally if every educator in our school
of pharmacy worked as diligently and practically as did
Proctor, our pharmacists of today would be well prepared
to face our current challenges.

AUGUST, 1982

William Skinner, (right) Chairman of the Centennial Celebration
Committee receives a surprise award from President Cogan in
recognition of his hard work in planning the many activities of the
Centennial year.

| urge each of you to learn more about these two men of
Maryland’s past and pattern your future professional di-
rection to correspond to theirs. The profession will benefit
in my opinion, and you will personally benefit as well.

A special work of thanks is due to President Phil Cogan
and about a dozen unnamed students of pharmacy who
contributed a day or two to help us wax, polish and dust
the basement museum room in preparation for the Spring
Regional Meeting.

Our students can always be counted on in a pinch and
we appreciate even their anonymous assistance.

This brings us to the present meeting to which your
committee has provided considerable input in developing
program and souvenirs. Rather than list each event the
Centennial Committee has developed or arranged, we will
ask you merely to compare this meeting with those you
have attended in previous years. If at the conclusion of the
meeting you think we have made a difference, then | hope
you will thank each of the Committee members you see
listed at the end of this report.

But what of the months to come? What plans have we
made and how will you participate in them?

A special effort has been planned to enlist a number of
the Association members in an Association Speakers
Bureau. Combining the resources of the Student CODAE
and ElderEd Program with some forthcoming speech ma-
terials and news releases from the USP, the Association
will shortly announce the availability of volunteer speakers
for schools, civil clubs, PTAs and other private or public
groups.

The reason for the speakers bureau effort is to
dramatize the pharmacy profession’s abilities to further
aid the public’s general and specific understanding of
drug use. This effort at this point is only a well reasoned
suggestion of your Centennial Celebration Committee.
What remains to be done is for us to identify where this
effort will be supported by you in aconscientious manner.

To make a real impact on the public, volunteers should
stand ready to make a minimum of two speeches, using
and adapting the materials supplied by the Association.
Here is the plan.

The Association will prepare and forward a general
announcement of the speakers bureau plan to all local
newspapers and school systems. The announcement will
suggest that groups wanting speakers will contact the As-
sociation office. At that point, we must match the request
with a speaker so that date arrangements may be made
with the requestor.

Hops

Sign up sheets for the Centennial Speaker Bureau are
available at the Convention tables and at the Baltimore
office. Signing up for this job does not preclude your
doing whatever public speaking you may now be engaged
in: we do not want to switch your allegiance or loyalty from
SCODAE or ElderEd if that is where you are now spending
your voluntary efforts. Please continue these.

We believe the materials that are to be supplied to all of
the Speakers Bureau volunteers will help you immeasur-
ably. If you have some ideas about speaking and want to
incorporate them into our plans, we certainly wish to hear
from you.

The Fall Regional Meeting will once again give us an
opportunity to emphasize the Centennial.

Let me close my remarks by asking each pharmacist
and each spouse to participate in our Centennial. Do this
by your active attendance throughout the year, by your
participation in the speakers bureau, in the sale of the USP
drug information books and by the purchase of our Cen-
tennial Jars and Lapel Pins. It has been my pleasure to
serve as your Centennial Chairman and | eagerly look for-
ward to each of you taking part in the next 100 years.

Committee Members Students on Clean-up

Benjamin Allen Terry Davis

Philip Cogan Dudley Demarest, Jr.
Morris Cooper Vicky Hale

Dudley Demarest, Jr. Bill Noonan

Brian Sanderoff
Taher Sheybani
Jane Stahovec

Mattie Feinberg

Ronald Lubman

Bennie Owens

Richard Parker

Stephen Provenza

Melvin Rubin

Roberta Van Duzer
William Skinner, Chairman

Membership Committee Report

As of 6/11/81 6/11/82
TOTAL MEMBERS TO DATE: 859 1024
NEW MEMBERS TO DATE: 68 219
COMPARISON:
MEMBERS TO DATE: +165
NEW MEMBERS TO DATE: +151

BREAKDOWN: 6/11/81 6/11/82 Comparison
Owner-Manager 205 205 0
Non-Owner 340 464 +124
Pledge—1st year 62 53 —9
2nd year 50 45 =O
Hospital 34 37 +3
Graduate e) 5 ==—4
Retired 68 81 +13
Non-Resident 44 88 +44
Joint 6 7 a
Associate 41 39 =
859 1024 +165

| would like to extend my fullest appreciation to the member-
ship committee for their time and efforts this year. The statistics
show that we are prospering even in a period of economic strife.
| would also like to invite new volunteers to be a part of this
committee. A few hours a year spent in any committee work
really gives one a sense of great accomplishment.

| would also like to extend by fullest appreciation to David
Banta and his staff for all the extra efforts they have contributed.

Frank Blatt
Chairman

(More Reports coming in the September issue)

MPhA Speakers Bureau is formed

SPEAKER’S
BUREAU

At the 1982 Centennial Convention, the Association kicked off
the MPhA Speakers Bureau. Newsreleases have been sent out
and a brochure describing this service will be prepared. The
June issue of the Maryland Pharmacist carries speaker out-
lines for your use. Sign up now to participate. Send the form
below to the MPhA office, 650 W. Lombard Street, Baltimore,
Maryland 21201.

Name
Address
City
Phone renee soe (1h) oe ee oe

Zip

THE MARYLAND PHARMACIST

When |

was the

last time

your
Insurance
agent

gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville. Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
PAUL FREIMAN & JOSEPH FREIMAN EVERY
YEAR! Usually for more than 20% of their
premium.

PAUL & JOE are two of the many Maryland
pharmacists participating in the Mayer and
Steinberg/MPhA Workmen’s Compensation
Program—underwritten by American

‘Druggists’ Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS...
call or write:

| Your American Druggists’ Insurance Co. Representative

=) AMERICAN
“\Y DRUGGISTS’
INSURANCE

Please contact me. | am interested in receiving more
information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. O Call OO Write

+

20

Thanks,

Philadelphia College of Pharmacy

ABBOTT

2043461

and Science

These young people recently spent a very full day
at Abbott, touching bases in research, development and
production.

Many of them were impressed— and said so— with
the hundreds of steps and precautions taken to assure a
top-quality product.

We were impressed, too— with them.

They were bright, curious, professional and very excited
about their careers.

It was a good day. And one way we know of starting —
and keeping — a dialogue.

THE MARYLAND PHARMACIST

area
se

7,
Uy ">
iii
QM sible

“three different cocktail parties!” Learning the basics at the Square Dance.

“O.K.—Has anyone seen the fashion show?” Waiting for Crabs.

This page donated by
District-Paramount
Photo Service.

DISTRICT PHOTO ING

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

Pictures courtesy Abe Bloom — District Photo

AUGUST, 1982 a

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the

St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

CIMETIDINE:

Cimetidine (Tagamet) has been used extensively for
several years, and thus drug interactions involving this
H-2 antagonist are being reported more frequently. The
alkalinization of the stomach seems to interfere with the
absorption of certain drugs which require acid media
for solubilization. The absorption of aspirin, and
ketoconazole is decreased by half in the presence of this
drug. Cimetadine has also been found to inhibit the me-
tabolism of warfarin, the benzodiazepines, phenytoin,
theophylline, and carbamazepine. These occur to dif-
ferent extents and are apparently due to the ability of
cimetidine to interfere with the heme-moiety of cyto-
chrome P-450. Additionally, a single dose of cimetidine
reduces hepatic blood flow, thus increasing the plasma
concentration of drugs which are usually removed by
first pass metabolism. Drugs which may accumulate via
this mechanism include propranolol and labetalol. Clin
Pharmacokinet, Vol. 7, #1, p. 23, 1982.

ACID SECRETION:

Prostaglandins have a considerable effect on the ac-
tivity of the gastrointestinal tract. Studies now show
that prostaglandin E-2 secreted directly at the site in the
stomach plays a major role in regulation (inhibitory in-
fluence) of parietal cell acid secretion. Aspirin inhibits
prostaglandin synthesis at the site by interfering with
cyclo-oxygenase activity thus reducing the concentra-
tion of prostaglandin E-2 and allowing for increased acid
secretion. J Pharmacol Exp Ther, Vol. 220, #2, p. 371,
1982.

LIPOSOMAL ENTRAPMENT:

Drugs can be emulsified with certain combinations
of fatty substances so as to put the drug in the core of
the fatty preparation. This essentially isolates the drug
thus reducing its toxicity when it is administered. In
order to be effective, the protective fatty barrier must
be removed at the point destined to be the site of action
of the drug. Cytosine arabinoside, a potent antineoplas-
tic agent, was placed in such a liposomal preparation.
Injections of the preparation were made into the
peritoneal cavities of patients with certain types of
cancer. The lymph vessels in that area pick up the en-
trapped antineoplastic agent and transport it to the
lymph nodes where the fatty layer is stripped away.
This technique may be useful in preventing spread of
metastatic cancers which spread via lymphatic path-
ways. Drug Metab Dispos, Vol. 10, #1, p. 40, 1982.

28

CYCLOPHOSPHAMIDE:

The plasma levels of certain drugs can be deter-
mined by measuring the concentration of the drug in the
saliva. A technique utilizing mass spectrometry has
proven valuable in determining the concentration of the
antineoplastic agent, cyclophosphamide, without re-
sorting to invasive techniques. Patient acceptance and
comfort is greater with this procedure. J Clin Phar-
macol, Vol. 21, #11, p. 461, 1982.

TRIMETHOPRIM:

Prior to the introduction of trimethoprim (Prolop-
rim, Trimpex) to the United States market as a single
drug entity, some investigators had claimed it was as
effective by itself as was the combination of it and sul-
famethazole (Bactrim, Septra). Others claimed the
combination was an excellent example of pharma-
cological potentiation produced by using two drugs
which affect consecutive pathways in biochemical se-
quences. Reports from Europe had indicated that re-
sistance readily developed to trimethoprim, but some in
this country doubted those reports. Recent evidence in-
dicates that resistance does indeed develop to the use of
trimethoprim alone. Studies conducted in patients tak-
ing the drug for a two week period of time while travel-
ing in Mexico showed that E. coli organisms especially
have a remarkable capacity for developing resistance to
this antibiotic. N Engl J Med, Vol. 306, #3, p. 130,
1982.

WEIGHT LOSS:

Balloons were placed into the stomach of five obese
women and then were inflated with a catheter and left to
float about freely in the organ. While inflated, the bal-
loon produced a feeling of satiety and the patient lost
weight because of reduced food intake. When the bal-
loon became deflated, it passed out uneventfully with
the stool. Before this method can be more universally
used, a balloon resistant to acid needs to be perfected.
Lancet, Vol. I, #8265, p. 198, 1982.

THEOPHYLLINE BIOAVAILABILITY:

Bioavailability of theophylline preparations can vary
extensively from product to product and thus many
brands cannot be interchanged indiscriminantly. Two
brand name products were examined in asthmatic pa-
tients to see if variation exists in response to these for-
mulations. Results indicated that Elixophyllin SR cap-
sules and TheoDur tablets produced comparable results
with respect to bioavailability, efficacy, and tolerance.
Clin Ther, Vol. 4, #4, p. 252, 1982.

THE MARYLAND PHARMACIST

Dave Schmidt and Harles Cone, Ph_D., teach you how to improve your professional
image, interpersonal relations, communications, how to understand, and even predict human
behavior. We call it Professional Development and consider it of great value to the pharmacy
profession. The Upjohn Company is proud to have been a pioneer in bringing these Pro-
fessional Development Programs to pharmacy. During the past 8 years, Dave, Harles and
others have presented scores of seminars for over 27,000 pharmacists. Perhaps you were

among them. 7 : Upjohn |
THESE TWO TEACH
YOU THINGS YOU
NEVER LEARNED
BEFORE -BUT WISH
YOU HAD.

© Gopyright 1981. The Upjohn Compan
» mazoo. Michigan: »

AUGUST, 1982

Y eye magazines, pepirback bowks
ee, Come baohk Ia dee ld

So ae a ZZ

That’s the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you’re not now offering periodicals to your customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

30 THE MARYLAND PHARMACIST

Classified Ads

Classified ads are a complimentary
service for members.

Pharmacy for Sale: Owner Retiring. Bambrick Pharmacy, Race &
Cedar St., Cambridge, Md. Call 228-0648.

WANTED TO BUY—Pharmacy, Baltimore area—at least volume of
$500,000 annually. Contact: Box 101, Association Office.

Professional pharmacy for sale, includes living quarters, very
good opportunity and investment. Call Ed Balcerzak, 433-7572.
FOR SALE:

UNIT DOSE PACKAGING MACHINE. UNIT PAK MODEL XL Il.

(Medical Packaging Inc.) Makes 1,000 sealed and labeled

packages (2 x 2”) in 20 minutes. 90 day warranty on parts & labor.

Reasonably priced. Will train you to use the equipment at no

charge. Larry H. Pozanek, Citizens Pharmacy Services, 415 S.

Market Street, Havre De Grace, Md. 21078 301-939-4404.
POSITION DESIRED

Pharmacist seeking employment in local pharmacy. Please write
or call John J. Selak, 216 Hickory Drive, Fayetteville, Pa. 17222 or
call 717-352-2619.

PHARMACY FOR SALE

Ideal location on corner lot, downtown Bel Air. Modern brick
building, 8474 sq. ft. floor space on two floors. Owner will sell
real estate, business, inventory and equipment. Priced to sell.
Worth looking into. Contact Chas. V. Spalding, Realtor, at 879-2500.

We at SELBY DRUG COMPANY
attribute our rapid growth and success
to our ability to make changes. These
changes are made rapidly, when and
where they are needed!!

The SELBY DRUG

management

team evaluates sources of supply twice
a year.

DO YOU?????

Maybe it’s time for you to evaluate
your present drug wholesaler.

For information on our Full Line pro-
gram, please call person-to-person collect
to:

Wallace Katz

Senior Vice President

SELBY DRUG COMPANY

633 Dowd Avenue
Elizabeth, NJ 07201
(201) 351-6700

AUGUST, 1982

TEL-MED PROGRAMS IN OPERATION
THROUGHOUT MARYLAND
Prince George's County
Cheverly
Sacred Heart Hospital
Cumberland

345-4080

777-8383

Provident Hospital
Baltimore

728-2900

University of Maryland Hospital ......................528-3111
Baltimore

Memorial Hospital
Easton

822-9198

CENTENNIAL MARKET

* Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

* Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

* The M.Ph.A. is offering to the public and its members
the USP publication, “About your Medicine.’ This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available—‘About your
High Blood Pressure Medicine’ —$3.00 each plus $1.00
postage and handling.

*The Pharmacy Art Print ‘“Secundem Artem” is avail-
able from the Association office. This 18” x 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

* Centennial Apothecary Jars with the Association's
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

3]

Art Prints Available
Maryland Pharmacy History

The Centennial Committee of the Association has commissioned a limited set of art prints depicting
historical sites in Maryland. These prints by noted artist Marian Quinn are each hand numbered and
signed by the artist. The prints are available from the Association Office at $7.50 each or four for
$25.00. They are ink line drawings that are certain to be collectors items in the future.

pie ar RAND COLE OF PRC —

Wj

UNIVERSITY OF MARYLAND SCHOOL OF PHARMACY
BALTIMORE 1877-1886

E.w. STERLING PHARMACY, CHURCH HILL, MO.
BUILT IN 1895

z a = =
SADLERS PHARMACY, LAUREL, MD.
Bul IN R69

_ eee et ae ee a es eae
i (Order Form) art print order form |
a ]
a ]
5 Name |
f |
¥ Address 4
a 4
4 4
, Phone :
i $
b Number of Prints at $ is $___ Total enclosed i
4 i
i i
" (Prints are $7.50 each or four for $25.00) i
: Mail this form and check made payable to MPhA to 650 West Lombard St., Baltimore, Maryland -
21201
& i

MPhA Testifies Before Congress

Etymology of Medical Terminology

— Stephen J. Provenza, Phar. D.

ASCP’s Statement on Pharmacy Education
-=Jerome E. bine, MS.,7P:D.

More Convention Reports

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 Nae,

SEPTEMBER 1982 VOL. 58 NO. 9

DAVID A. BANTA, Editor
CONTENTS BEVERLY LITSINGER, Assistant Editor

ABRIAN BLOOM, Photographer

3 President’s Message
Officers and Board of Trustees
1982-83
4 MPhA Testifies before Congress Re Preon
on Pharmacy Burglaries WILLIAM J. KINNARD JR., Ph.D. — Baltimore

President
MILSON SAPPE, P.D. — Baltimore
Vice-President

6 The Etymology of Medical Terminology

— Stephen J. Provenza, Phar. D. WILLIAM C. HILL, P.D. — Easton
Treasurer
10 Centennial Convention Reports MELVIN RUBIN, P.D. — Baltimore

Executive Director

DAVID A. BANTA, C.A.E. — Baltimore
Executive Director Emeritus

NATHAN GRUZ, P.D. — Baltimore

16 Your Peer Review Committee in Action

20 ASCP’s Statement on Pharmacy Education
— Jerome L. Fine, M.S., P.D. TRUSTEES
PHILIP H. COGAN, P.D. — Chairman

22 Feldene Review Laurel
RONALD SANFORD, P.D. (1985)
Catonsville

28 Abstracts JAMES TERBORG, P.D. (1985)
Aberdeen

DEPARTMENTS GEORGE C. VOXAKIS, P.D. (1984)

Baltimore
BARBARA BARRON, P.D. (1983)

31 Calendar Rising Sun, Maryland
CHERYL BETZ, SAPhA (1983)
31 Classified Ads Baltimore

1S Letters to the Editor EX-OFFICIO MEMBER

WILLIAM J. KINNARD, JR., Ph.D. — Baltimore

ADVERTISERS HOUSE OF DELEGATES
herd : Speaker
23 District-Paramount Photo 19 Mayer and Steinberg : .
eee ANT ROWN, P.D. — Sil S
8 Eli Lilly and Co. 13 Selby Drug Co. Se ON ilver Spring
9 Loewy Drug Co. 18 Smith, Kline and French Vice Speaker

HARRY HAMET, P.D. — Baltimore

30 Maryland News Distributing 14 Upjohn

MARYLAND BOARD OF PHARMACY
Honorary President

Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN, P.D. — Salisbury
new address with zip code number. Allow four weeks for changeover. APhA member — : a
please include APhA number. President

BERNARD B. LACHMAN, P.D. — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore

part of their annual membership dues. Entered as second class matter at Baltimore, Mary-
land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 6150 West Lombard Street, Baltimore, Maryland 21201.

ANTHONY G. PADUSSIS, P.D. — Timonium
PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

os THE MARYLAND PHARMACIST

President's Message

Blocadren, Calan, Dolobid, Feldene, Midamor, Oraflex, Procardia, etc.,
etc.—all new drugs. All are in stock either because they were received on
automatic shipment or ordered through our wholesale salesman. We received
the package inserts, the usual accompanying literature, postal and periodical
advertisements. But where was the manufacturers representative? It was only
in the case of Oraflex that we saw a representative from one of the major drug
manufacturers. Speaking now as community pharmacy owner, I often wonder if
physicians are asked as many questions as we are in direct conversation with
the patient or later on the phone. I take this as great complement to our profes-
sion. Granted, a large percentage of the questions are answered through com-
mon sense, but others more complicated, may mean placing the patient on hold
and looking up the appropriate information. Yes, I try to read the inserts, the
incoming mail and anything else available, but if you are like me, the mail and
reading matter piles up. Much of my education is reactionary. In other words, it
is a direct result of a patient’s question.

Major drug manufacturers are my biggest problem in this area, especially
with their automatic shipments. There does not seem to be any personal
follow-up. The manufacturers have enormous amounts of money to spend on
development, detailing, sampling and promotional literature, and yet so little
time to see me and those like me who are on the very edge of patient care. I
realize that the prescription originates in the doctor’s office and because huge
amounts of money are needed to deliver a new drug to the market place, an
economic factor is involved, but what about patient care? Manufacturers are
responsible for this valuable information and for ensuring that it is adequately
disseminated to all health care providers, especially in the case of new drug
entities. I realize that it will be said that some pharmacists will not take the time
to see detail persons, but this is not a new charge. Physicians are guilty of this
also. It seems to boil down to that bottom line. Yet is not some regard due to
patient care. In today’s environment, with all of the new drugs coming onto the
market and all the new drug being tested and used abroad, it is imperative that
the dispensing community pharmacist be given information promptly and con-
cisely so that the patient may best be served.

Milton Sappe,

PRESIDENT

SEPTEMBER, 1982

MPhA Testifies Before Congress
On Pharmacy Burglaries

Mr. Chairman and members of the Committee, | am
David Banta, Executive Director of the Maryland Phar-
maceutical Association. The Association is the state-wide
professional society of pharmacists in Maryland with over
1000 members. | appreciate this opportunity to appear
before the Subcommittee on Criminal law to testify in sup-
port of bills dealing with the increasing problem of phar-
macy robberies.

On April 7, 1982, the pharmacy community in Maryland
was again rocked by the newspaper headlines that another
of our colleagues had been senselessly shot and critically
wounded during a burglary of his pharmacy. Pharmacist
Robert Kantorski was working in his pharmacy, the Ritchie
Prescription Pharmacy in Brooklyn Park Maryland, when
two armed robbers demanded drugs. Mr. Kantorski was
complying with their orders when he was shot three times.
This kind of irrational violence has become all too familiar
to Maryland Pharmacists.

Several months ago, The Village Pharmacy in Gaith-
ersburg, Maryland was robbed by an armed female who
held the pharmacist at gun point while a clerk gathered the
powerful narcotic, Dilaudid, which the robber demanded.

The McAlpine Pharmacy in Ellicott City, Maryland was
also the recent target of an armed hold-up. The two rob-
bers held the pharmacist and store employees at gunpoint
while searching for drugs. They ignored the money in the
cash register and took only the drugs they were seeking.

Pharmacists in Maryland remember the death of Phar-
macist David McLarty who was gunned down in his Lin-
thicum Pharmacy by robbers after the narcotic drugs in
Pharmacy.

These incidents of violence appear to be increasing
annually and it has cast a deepening shadow over the
practice of pharmacy.

| believe there are several reasons for this increase in
violence directed against pharmacists. The quantity and
quality of street-drugs has apparently dryed up due to in-
creased effective law-enforcement activity. Addicts are
faced with undependable supplies of the narcotics they
must have. In their minds, the robbery of apharmacy witha
weapon is less hazardous than the drug buy in the dark
alley with its own potential for violence and rip-offs. These
are desperate individuals. They are prone to irrational be-
havior and spontaneous violence. The pharmacist knows
that when he or she is confronted by such an addict de-
manding drugs, that casual but fatal violence is a definite
possibility even as the robbers demands are being met.

The effect of all of this on the profession of pharmacy
has been profound. It is impossible to talk to a pharmacist
who has been in practice for only a few years who has not
endured the trauma of a robbery. It is the most frightening
experience you can imagine. As small businessmen,
pharmacists have had to deal with the possibility of a rob-
bery or burglary in the past. But these new crimes involv-
ing drugs and their increasing trend, represents a new and
more severe threat to our profession.

The pharmacy profession is proud of the fact that it is

Incidence of Pharmacy Robberies
to Obtain Controlled Substances* 1973-1981

160% Increase
1070
76 Ze

= © > Cc OD aS Ww OC

Robberies (Hundreds)
1279
988
73 74 75

*Source: DEA

78 79 80 81

Year

Reprinted by permission of NARD Journal, © 1982, National Association of Retail Druggists

so widely accessible to the public. Pharmacy does not
have the manpower distribution problem that other health
care professionals experience. The pharmacist is on every
Main Street in America, providing patient information and
quality pharmaceuticals to the public. Yet it is that very
accessibility that is threatened. For example, in Baltimore
City, it is now impossible to find a 24-hour community
pharmacy. Increased pharmacy robberies during the late
evening and early morning hours have forced Baltimore
area pharmacists to stop this community service. Working
with our Association and the Board of Pharmacy, several
pharmacists have made arrangements to provide after-
hour service to patients with emergency prescriptions; but
they will make the special trip to open their pharmacies
only if a law-enforcement officer is also present.

There are other effects. Many newly graduated phar-
macists are now turning away from the practice of com-
munity retail pharmacy because of the increased potential
for violence. The pharmacy schools are now approxi-
mately half male and half female in enrollment. Many of
these students are choosing to enter hospital pharmacy
practice, manufacturing or other areas of the profession
rather than work in community practice. Yet we now have
seen reports where even hospital pharmacies have been
robbed by those in search of these drugs. Some commu-

THE MARYLAND PHARMACIST

nity pharmacies that have been repeatedly robbed have
great difficulty recruiting pharmacists to work.

Pharmacy is a public and patient oriented health care
profession. Today's pharmacist is trained to interact with
the public and provide valuable medication information.
Unfortunately the trend in pharmacy violence has had the
effect of making some pharmacists defensive. A pharma-
cist must constantly be on guard and watchful for the one
patient who approaches with the wild-eyed look and the
concealed weapon.

In Towson, Maryland, Kaufmann’s Pharmacy posted a
sign in its window informing the public and potential rob-
bers that it no longer carried Schedule II prescription
drugs after it was robbed twice in one month. Most pharma-
cists have not chosen to do this because of their desire to
serve the public health. But this drastic measure is a
symptom of the defensiveness | have observed in Maryland
Pharmacists.

Pharmacists have now armed themselves. As | attend
continuing education seminars and other pharmacy
meetings, | have noted that more and more pharmacists,
especially those who have experienced robberies in the
past, are armed for self-protection. It is a sad commentary
on our society when individuals engaged in a health care
occupation in the community are forced to carry the very
tools of violence for their own self-protection.

| Know that there can be little disagreement about the
nature and scope of this problem. | also realized that a
complete and total solution for what is only one manifes-
tation of a deeply rooted problem in our society is not
within our grasp. There are, however, some measures that
can be taken which will act as a deterrent to the violence |
have described. | urge the Committee to support the intent
of Senate Bills 20, 661, 954, 1025, and 1339. Something
must be done to assist the pharmacists in this country who
are quite literally, risking their lives due to the unique na-
ture of their trade. | urge that you seriously consider man-
datory minimum penalties for those convicted of Phar-
macy robberies. Send a message to those addicts who
believe that knocking over the neighborhood pharmacy is
the easy way to secure drugs. We ask you to take firm and
positive action to strengthen the prosecution and penal-
ties for those who would rob pharmacies.

The MPhA was invited to present testimony before a Senate Con-
gressional Committee on the subject of pharmacy burglaries.
Presenting testimony in favor of tightening penalties and making
pharmacy burglaries a Federal crime are: (left to right) Melvin
Rubin, MPhA Treasurer; David Banta, MPhA Executive Director;
Sheldon Fantle, Peoples Drug Stores; and Stanley Siegelman,
Editor-in-Chief of American Druggist.

SEPTEMBER, 1982

Thank you again for this opportunity to testify before
this Committee. | would be pleased to attempt to answer
your questions.

Mr. Chairman and members of the committee, my name
is Melvin Rubin. | am the owner of J. and S. Pharmacy, a
practicing pharmacist in Arbustus, Maryland. The prob-
lems of pharmacy robberies is more than just a growing
statistic to those persons who have been at the wrong end
of a gun held by a glassy-eyed addict. Twice in the past 12
months or so my pharmacy, which is in a middle class
neighborhood has had unsocial calls from persons willing
to risk jail for drugs—during daylights hours, in a well lit,
fully exposed to walking traffic location.

Nothing in my pharmacy is inviting to an addict—it is
small, the windows are completely open to view across the
expanse of the building, and stores on either side have
continuous traffic. Nothing is inviting except one thing—
the drugs that cost me comparatively little but are worth
great risk to the robber.

Our last holdup cost us about $600 in merchandise—
almost completely it cleaned out our schedule Il items plus
select Ill drugs, yet it was worth the armed robbery convic-
tion that might have followed.

lronically, these two holdups came the same day the
police made a bust in illegal narcotic traffic in the area. My
problem then, is that the more effort that is used to break
up these rings, the more threatening the situation be-
comes for those of us on the hot spot—with the drugs in
stock when the need is there.

This is more than a situation where a merchant needs
police protection. Being robbed for money and merchan-
dise other than drugs means being confronted by a person
who at least might be rational—might understand that pull-
ing the trigger is going to put him in even more jeopardy.
Being confronted by a person whose eyes are so wild
looking that they are still clear in my mind is another
problem—certainly reasoning will not help and the only
thing you can do is hope he leaves, before the urge comes
to squeeze. You even have to hope the police will not hap-
pen on the scene until he leaves or you can expect to go
with him. If you are left able to move at all.

Certainly the situation calls for a better system of pro-
tection for pharmacies and absolutely for stiffer penalties
for those caught. In the case of irrational people, the only
deterrent is keeping them where they are not in contact
with the population.

The Testimony was given before Maryland Senator Mathias’s
Subcommittee on Criminal Justice on June 17, 1982.

‘n

The Etymology of
Medical Terminology

by Stephen J. Provenza, Phar.D.

Shakespeare is regarded as the greatest English poet
and dramatist. His education is often regarded as having
‘little Latin and less Greek.’’ He succeeded in his out-
standing career because he was determined to over-
come this short-coming.

Because Shakespeare’s son-in-law was a physician
his iridescent intellect could not fail to appraise the
medical profession. A study of his plays gives a sur-
prising insight into his views—often clairvoyant—on the
healing art as a science.

The pharmaceutical, medical and dental student is
often unable to use his or her knowledge of the classical
languages in determining the etymology and meaning of
the ordinary basic medical scientific terms used in anat-
omy, physiology and pathology. This is true because the
classics that they have studied are more from the liter-
ary rather than from the philological point of view. We
find that the Greek terms were Latinized and were sub-
sequently modified in France; we ourselves have been,
and still are, anglicizing them. Any pretense of obeying

the rules of Greek or Latin grammar has been aban-
doned.

By studying the list of words that have been given in
this study, the anatomical terms in many instances are
derived from the Latin whereas the pathological terms
are from the Greek. It can be proven by consulting a
medical dictionary that 75% of the present English
medical terms can be traced to the Greek of Hippoc-
rates who was born about 480 B.C.

Many recent medical terms in the fields of bacteriol-
ogy, pharmacology and psychiatry were created by
using the everyday Latin vocabulary. Many of these
words vary in their spelling.

Approximately 25% of the words in the medical dic-
tionary are formed with the aid of a prefix or a suffix—
indicating their importance.

The following are many basic medical words:

English Latin Example
All Omnis Omniscience
Ankle Talus Talipes
Bed Lectus Lectularis
Bird Avis Aviator
Black Niger Nigronfier
Bladder Vesica Vesicle
Blood Sanguis Sanguinary
Break Ruptis Rupture
Breath Spiro Aspire
Buttocks Natis Nates
Cheek Bucca Bucca Sulcus
Chest Pectus Pectoral
Coal Carbo Carbon
Cross Crux Crucifix
Digest Digero Digest
Ditch Fossa Fossula
Drug Medicatus Medicated
Dry Siccus Desiccator
Dust Pulvis Pulverize
Ear Auris Auritis

Egg Ovum Ovate

Eye Oculus Oculist
Eye Lid Palpebra Palpetral
Fast Rapidus Rapid

Fat Adeps Adipose
Finger Digitis Digit

Greek Example
Pan Panorama
Astragalos Astractalar
Kline Clinic
Ornis Ornithology
Melas Melanoma
Cystis Cystitis
Haima Hemorrhage
Thrypsis Lithotrypsy
Pnoe Apnea (Not Breathing)
Gloutos Gluteus
Melo Meloplasty
Stethos Stethoscope
Anthrax Anthracosis
Gammation Gamma Rays
Pepsis Syspepsia
Taphros Taphronose
Pharmacon Pharmacist
Dipsa Dipsomaniac
Konis Coniosis
Otos Otitis
Oon Oocyst
Ophthalmos Ophthalmology
Blepharon Blepharitis
Tachys Tachometer
Lipos Lipase
Daktylos Dactyl

THE MARYLAND PHARMACIST

English

First
Fish
Foot
Fork
Glass
Gold
Grape
Gray
Green
Gut
Hair
Hand
Head
Heat
Hip
Hole
Horn
Horse
Hundred
Ice
Jaw
Knee
Kidney
Know
Lip
Liver
Lung
Marrow
Milk
Moon
Mouth
Muscle
Nail
Nipple
Nose
Oil
Pestle
Purple
Pus
Rabbit
Red
Seed
Shake
Silver
Skin
Sleep
Slow
Sole
Spleen
Spit
Star
Starch
Stone
Sweat
Sweet
Tears
Testicle
Thick
Tongue
Tooth
Thousand
Throat
Tube
Vein

Warts & corns

Water
White
Window
Wine
Womb
Yellow

SEPTEMBER, 1982

Latin

Primus
Piscis
Pedis
Furca
Vitrium
Aurum
Uva
Cinis
Viridis
Intestina
Capillus
Manus
Caput
Caldus
Coxa
Foramen
Cornu
Equus
Centum
Glacies
Mandible
Genu
Renis
Doctus
Labium
Jecoris
Pulmo
Medulla
Lac
Luna
Oris
Musculis
Unguis
Papilla
Nasus
Cleum
Pistillum
Purpura
Puris
Cuniculus
Ruber
Semen
Tremo
Argentum
Cutis
Somnus
Tardus
Planta
Lien
Saliva
Stella
Farina
Lapis
Sudor
Dulcis
Lacrima
Testis
Solidus
Lingua
Dentis
Mille
Fauces
Fistula
Vena
Verruca
Aqua
Albas
Fenestra
Vinum
Uterus
Luteus

Example

Prime
Piscator
Pedal
Bifurcation
Vitreous
Auriger
Uvala
Incinerator
Verdant
Entera
Capillary
Manual
Capital
Calorific
Coxalgia
Opening
Corneus
Equine
Centimeter
Glacial
Maxillary
Genuflect
Suprarenal
Doctor
Labial
Jecoral
Pulmonary
Medullaris
Lactation
Lunar
Osculate
Muscular
Finger nail
Papillate
Nasal
Cleaceue
Pistillate
Porphyritic
Purulent
Burrow
Rouge
Seminal
Tremble
Argentio
Cuticula
Somnific
Retard
Plantar
Lienitis
Salivary
Constellation
Farinose
Lapillus
Sudorific
Dulcifer
Lacrimal
Testosterone
Solid
Linguist
Dentist
Milleped
Suffocate
Pipe
Venation
Verrycosus
Aquatic
Albino
Fenestration
Vineyard
Uterine
Lutien

Greek

Proto
Ichthys
Podos
Bisulcus
Hyalos
Chrysos
Staphle
Polios
Chloros
Enteron
Trichos
Cheir
Kephale
Therme
Ischion
Hiatus
Keratin
Hippos
Hekaton
Kryos
Gnathos
Gonatos
Nephros
Sophos
Cheilos
Hepar
Pneumon
Myelos
Galaktos
Mene
Stoma
Myos
Onycho
Thele
Rhinos
Lipos
Tripter
Porphyria
Pyon
Lagos
Erythros
Sperma
Seismos
Argyrols
Derma
Hypnos
Bradys
Pelma
Splenos
Sialon
Aster
Amylon
Lithos
Hidros
Glykeros
Dakryon
Orchis
Pachys
Glossa
Odontos
Kilo
Larynx
Solen
Phlebos
Helos
Hydatos
Leukos
Phoster
Methy
Hystera
Xanthos

Example

Prototype
Ichthyology
Podiatry
Cloven
Hyaline
Chrysinos
Staphylococcus
Poliomyelitis
Chlorophyll
Enterocele
Perithrix
Chiurgic
Cephalic
Thermometer
Sciatica
Vacant Space
Keratitis
Hippuric
Hectogram
Cryotherapy
Gnathic
Gonagra
Nephrosis
Philosopher
Chiloma
Hepatitis
Pneumonia
Myelitis
Galactic
Meniskos
Stomatitis
Myology
Finger & toe nails
Thelitis
Rhinitis
Lipase
Trypsin
Porphyrins
Pyorrhea
Lagophthalmos
Erythromycin
Spermatic
Seismatias
Argyrol
Dermatosis
Hypnosis
Bradycardia
Pelmatogram
Splenod
Sialogogue
Astronomy
Amyloidosis
Lithosis
Hidrosis
Glycosuria
Dacryops
Orchitis
Pachyderm
Glossary
Odontology
Kilometer
Laryngeal
Solenarion
Phlebitis
Helosis
Hydrometer
Leukorrhea
Phosterkokos
Methysos
Hysterectomy
Xanthosis

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Divisions of

Centennial Convention

Executive Director Report

| am personally honored to deliver the report of the
Executive Director at this, our one-hundredth Annual Con-
vention. It has been an eventful year since my last report.
Now that we are in the midst of our Centennial Celebration
| often have paused during the accomplishments of this
Association to reflect back on those who have met before
us. Just as the pharmacists in 1882 saw that there was a
need for a strong association of colleagues to face the
challenges of that day, so there is now a greater and con-
tinuing need for a strong Maryland Pharmaceutical As-
sociation. Beginning with about 25 members, this State
Association rapidly grew and assumed a respected posi-
tion within the health care community. We have a long
tradition of innovation and leadership. | have reflected
upon our Centennial theme. ‘‘Remembering where we
have been—Deciding where we are going.’ During the
rush of the daily administrative management of this As-
sociation, it has often been far too easy for me to lose my
sense of perspective. | wonder if the pharmacists who
gathered so long ago could envision where it would all
lead and how far we would progress. They saw many of
their own desires and plans for the Association come to
reality in those early days. Through their sacrifice and
foresight, we are here today praising their leadership. |
hope that we too have that sense of purpose and resolve to
continue to build a stronger Association. Certainly the
challenges facing us today grow more formidable each
year. | am confident that, as we remember our past, we will
make the correct decisions about our future.

Many of the accomplishments of the Association dur-
ing this past year are reviewed in the various committee
reports that are presented to this House. | would like to
touch on a few highlights and personal observations.

President Cogan brought strong leadership to his of-
fice and a specific goal of assisting local Associations as
much as possible. Beginning with a leadership conference
at last year’s Convention, he has visited virtually every ac-
tive local association in the State and personally offered
the assistance of the M.Ph.A. We have witnessed the for-
mation of the Frederick County Pharmacists Association.
Working through the Continuing Education Coordinating
Council, new programs were established for local associ-
ation use. He was successful.

Another longtime goal of this Association was to break
1000 members in time for our Centennial year. As you can
see from the membership committee report, we not only
broke this mark, we shattered it.

After this House of Delegates adopted the official
change in professional designation, at last year’s conven-
tion the Association has worked throughout the year to
accomplish a gradual phase-in. The P.D. designation has
now been adopted by many Maryland Pharmacists.

Another highlight of this past year came when the
Association succeeded in accomplishing the intent of a

10

MARYLAND
PHARMACEUTICAL
ASSOCIATION

resolution which was passed by this House of Delegates
several years ago—to repeal the mandatory/Price Poster. |
believe this is an excellent example of the “resolution
process’ at work. The leadership of the Association con-
tinues to devote resources to bring to reality the policy
direction that you as delegates and members provide.

Earlier this year, the Association was informed that it
might lose the Kelly Memorial Building due to expansion
of University Hospital. However, due to budgetary cut-
back, the new extension is not as large as originally pro-
jected and the Kelly building will remain where it is. With
that Knowledge we began to upgrade the building; in-
cluding a complete repainting of the exterior. While reor-
ganizing the interior, we created additional office space
which has been rented to an Episcopal campus minister as
another source of Association revenue. In conjunction
with the Spring Regional meeting—a new Building iden-
tification sign was erected on the front lawn.

The Association changed printers for the Maryland
Pharmacist to make it less expensive to produce while
maintaining a high level of quality. Charles Spigelmire was
honored for his 25 years of producing the radio show,
“Your Best Neighbor” the longest continuously produced
public service radio show in the state. Charlie was re-
placed by Phil Weiner who continues the show for the
Association in this fine tradition.

| wish to commend the work of the Centennial Celebra-
tion Committee and its Chairman William Skinner. Bill did
a terrific job of planning over the past three years. The
Association has provided its members and friends a com-
memorative apothecary jar, attractive pins, and historical
pharmacy prints. The Association has sold to the public
the USP books ‘About Your Medicines” and ‘‘About Your
High Blood Pressure Medicines” to inform others of our
Centennial. Among other items the Association has suc-
cessfully promoted, the special mounting plaques have
been particularly popular with the members.

In other areas, | thought it was especially significant
that the Association supported the Division of Drug Con-
trol with a contribution to publish an emergency newslet-
ter vital information. A contribution was also made to the
Poison Control Center in support of National Poison Pre-
vention Week Activities.

Legislation was another bright spot for the Association.
Working with the Code Commission, we saw the success-
ful completion of the recodification of the Pharmacy Prac-
tices Act. | have already mentioned the repeal of the price
poster. We were also successful in lobbying for a 30-Cent
increase in the Medicaid Dispensing fee—taking it to
$3.25. Working with the results of the new cost survey, we
hope to provide justification for more increases in the fu-
ture.

These were a few of the many issues which we grap-
pled with over this past year. Much remains for us to do.

1am very excited about the purchase by the Association
of a word processor. | believe it will place us into a new era

THE MARYLAND PHARMACIST

in terms of efficiency and membership services. New and
continuing challenges face us. The issues of prescriptive
authority for allied health care groups and our role in this
process remains to be clarified. The Association will de-
cide how to deal with the issue of chemically impaired
pharmacists. We must continue to improve the relation-
ship that exists between all state pharmacy organizations.
We must continue to fight for the economic survival of the
independent practitioner. We must continue the fight to
expand the scope of care that pharmacists can provide to
the public and receive remuneration for it. WE must work
to foster a better public understanding of our unique
knowledge base and contribution to the health care deliv-
ery system. And we must work for unity of purpose and a
consensus of professional goals among a// pharmacists;
regardless of practice specialty, academic degree or pre-
vious experiences.

| personally believe in the group process. Our Associa-
tion is the viable instrument for determining the collective
destiny of this profession. Those who do not join this pro-
cess have, by defacto, made a critical decision on issues
we will decide in the near future.

Perhaps events moved more slowly 100 years ago. Still
pharmacists perceived the need to band together for the
common good. Our ‘“super-sonic” age calls upon us to
continually adapt and seek better solutions to our mutual
problems. While | continue to be fascinated with the rich
heritage of Maryland Pharmacy, | am equally excited about
the prospects for future challenge. Successfully meeting
those challenges will permit us to soar into the future so
that, one hundred years from now, those who will come
after us will perhaps say our labors for pharmacy were
successful in ways we cannot now even imagine.

Thank you.

David A. Banta
Executive Director

The Student American
Pharmaceutical Association Report

The Student American Pharmaceutical Association,
University of Maryland, Maryland Pharmaceutical Associ-
ation, (SAPhA) has had a very successful year. This past
year SAPhA directed its activities toward increasing stu-
dent participation, faculty involvement and stronger stu-
dent, faculty and pharmacist unity. Along with these goals,
we were able to increase membership more than 25%, with
this years membership more taking a more active part in
SAPhA’s activities.

Our chapter participated in many fund raising activities
this past year. Some of the activities included bake sales,
raffles, T-shirts and book sales. All of the money that was
raised helped support students who attended the fall re-
gional and 1982 Annual SAPhA meetings.

This year our chapter also tried to identify Pharmacy
students with the other professions by sponsoring an
interdisciplinary program in which all professional stu-
dents were invited to attend. This program entitled, “Sex
Education in Today’s Society, The Effect on the Health
Professional’, involved mime that portrayed many situa-
tion problems teenagers face today and how the health
professionals may help in these various incidences. This
year we also presented 2 biannual coffeehouses in which
the entire UMAB campus, faculty and pharmacists were
invited to attend and participate.

Our chapter was also involved in many programs which
benefited the community. We participated in taking blood
pressures as well as helped Rutgers University in cooper-

SEPTEMBER, 1982

Out-going President Philip Cogan (right), receives a Special
Award from SAPhA President Chery! Betz (left) on the occasion
of the Association’s Centennial Celebration. The Plaque is on dis-
play in the Kelly Building with other Commemorative awards
given to the Association during the past year.

ation with the New Jersey Pharmaceutical Association es-
tablish an Elder Ed program in their state similar to the one
in Maryland.

This year we also undertook the project on redoing the
museum in the Kelly Memorial Building. Several students
worked a few hard weekends to refurbish the museum for
visitors.

During the meetings held this year our SAPhA chapter
was very fortunate to have two of its members Taher
Sheybani and Brian Sanderoff run for national office and
Dudley Demarest who was the Speaker of the House at the
national meeting held in Las Vegas.

Probably the most rewarding project for myself and the
chapter has been working on this year’s regional meeting
which will take place here this fallon November 4~—7 at the
Baltimore Hilton. The meeting entitled “Communicate
Professionalism” is an opportunity for students, faculty
and practicing pharmacists to all participate. Everyone is
invited to-attend and participate at the meetings and ban-
quets at the low fee of $20.00. Further information will be
available later on.

In conclusion, on behalf of our chapter of SAPhA, |
would like to take this opportunity to congratulate the
MPhA on your Centennial year, as well as thank you for
your continued support. We are thankful for the relation-
ship our student chapter has with the state association
because it has enabled us to interact directly with the as-
sociation and given us an opportunity to get involved in
many leadership roles.

| would also like to take this opportunity to thank sev-
eral people who have directly supported SAPHhA this year
and in the past, and without them our chapter would not
have progressed as far as it has. They are: MPhA; MPhA
Staff—Dave, Bev & Mary Anne, School of Pharmacy
Alumni Association; School of Pharmacy Faculty; Donald
Fedder—Our Faculty Advisor; Dean William Kinnard; Dean
Leavitt—Our Faculty Treasurer; and most importantly the
students at the school of pharmacy who without you
SAPhA would not have existed at all.

Finally, SAPhA hopes the next 100 years of the Mary-
land Pharmaceutical Association will be as eventful to the
Maryland pharmacists and students as the past.

Cheryl Betz

I]

Convention
Reports

Report of the Speaker of the House
of Delegates

Traditionally, at the Annual Convention, the Speaker of
the House of Delegates is asked to report on the general
membership meetings held during the year. It pleases me
to observe that, as this Association enters its second cen-
tury, we took some innovative approaches to both our Fall
and Spring meetings.

The Fall Regional, held at the Quality Inn in Catonsville,
was devoted to a continuing education program jointly
sponsored by this Association and the Continuing Educa-
tion Coordinating Council, a first for such a cooperative
effort. The Smith, Kline and French Company presented an
individually paced video-tape program on Personal and
Personnel Management. The House of Delegates meeting
was suspended as there was no business to be transacted.

The 1982 Spring Regional meeting was held in the Kelly
Memorial Building and the Association formally kicked off
its Centennial Celebration with the dedication of a sign
placed on the front lawn to identify the building and com-
memorate our 100th anniversary. Centennial Committee
Chairman William Skinner presented Association presi-
dent Phil Cogan with a plaque honoring Maryland Phar-
macists William Proctor and David Stewart.

The rest of the meeting was devoted to an issues forum.
The intention of this program was to discuss future direc-
tions for the Association. Representatives from various
pharmacy organizations in Maryland were invited to ex-
press what they saw as major issues for both MPhA and
pharmacy in Maryland. Dean William Kinnard, (School of
Pharmacy), Bernard Lachman, (president, Maryland Board
of Pharmacy), Bill Grove (President Maryland Society of
Hospital Pharmacist), Ron Tekak (Past President, Mary-
land Society of Hospital Pharmacist), Marty Mintz (Presi-
dent, Md. Chapter, American Society of Consulting Phar-
macists) and Phil Cogan (President, MPhA) made brief
opening statements on how they view the major issues in
pharmacy. The rest of the meeting was opened for discus-
sion from the floor. Matters dealing with economic issues
and curriculum changes were emphasized, but primarily
we focused on the quality of care to the public as our
major concern. We all agreed that we need to continue to
work for closer cooperation among all the pharmacy or-
ganizations in Maryland as one way of achieving our goals.
We were delighted to see, in addition to our members,
guests from other local and neighboring national associa-
tions. The program was well received. Following the pro-
gram, a wine and cheese reception was held on the lower
level of the Kelly Building, and | would note this too, was
well received!

My report would not be complete without expressing
my gratitude to David Banta, Executive Director of M.Ph.A.
for his support and enthusiasm as well as his guidance in
planning the programs for the Association.

Madaline Feinberg

Continuing Education Coordinating
Council Report

The Continuing Education Coordinating Council has
just completed another successful season of providing
continuing education opportunities to Maryland Pharma-
cists. | believe that we can all be proud of our Association's
participation in this unique, tripartite, cooperative effort
that has proved to be beneficial to all concerned. | wish to
offer a personal expression of appreciation to all of those
who serve on the Council and who have freely given of
their time over the past year to plan and execute these
programs.

Over this past season, the Council provided programs
on the following subjects, Personal/Personnel Manage-
ment (in conjunction with the M.Ph.A.’s Fall Regional
Meeting), Pulmonary Diseases, Pediatrics and Drug Ther-
apy during pregnancy, and Oncology. In addition to these,
the Council decided to advance program resources avail-
able outside the Metropolitan area by initiating the “New
Drug Road Show’. By identifying a number of qualified
volunteer speakers, we were able to offer this popular pro-
gram to the seven local Associations in Maryland. Virtually
all of them took advantage of this opportunity and the
Council plans to make this road show a permanent of-
fering.

For the coming season, the Council has arranged for
additional programs to meet the educational needs of
Maryland Pharmacist. We have selected these based on
responses to our program evaluations. The Council has
attempted to become sensitive to the comments of Phar-
macists so we might improve our program offerings. Sub-
jects to be offered include: Cardiovascular Drugs, Dia-
betes Mellitus, Alcoholism, Rheumatoid Arthritis, and
Stress. The Council will be issuing detailed announce-
ments about these programs for interested Maryland
Pharmacists.

The Council is also interested in involving individuals
who wish to assist in planning continuing education op-
portunities. | think you can tell that the Council is a very
active and productive organization. It is successful due to
the individuals who have taken the time and effort to par-
ticipate in this worthwhile activity. Please contact me if you
have any suggestion for the Council or if you wish to be-
come an active contributor to the Council’s work.

David Banta
Chairman

Past Speaker of the House Madeline Feinberg (left) receives the

Out-Going Speaker Award from Charles Spiglemire (right), the
Centennial Convention Banquet Grand Marshall.

THE MARYLAND PHARMACIST

William Skinner, General Counsel for the U.S. PharmPAC delivers
his report to the business session of the House of Delegates.

The United States Pharmacists
Political Action Committee Report

The officers and board members of U.S. Pharm PAC
join with me in saluting the Maryland Pharmaceutical As-
sociation on its 100th anniversary meeting. Compared to
the age U.S. Pharm PAC started in 1978, the Maryland As-
sociation is a great grandfather.

We should add that the Maryland Association is a really
great grandfather for more reasons than age. Among the
more professionally motivated pharmacists of the nation,
several Marylanders have taken leading roles in helping to
establish and carry on political activities on behalf of the
nation’s pharmacists.

Richard D. Parker, a past president of this Association
and the organizing treasurer of U.S. Pharm PAC stepped
down during the year as treasurer and in his place the
board elected Allen J. Brands. Allen Brands, a University of
Southern California pharmacy graduate, retired in 1981 as
the Chief Pharmacy of the Public Health Service at the
rank of Vice Admiral—the first pharmacist to ever gain the
flag rank as a pharmacist.

Another bright star in Maryland is U.S. Pharm PAC
Board Member Stan Yaffe, a stalwart member and worker
of your association. Without the dedication, hard work and
constant support of men like these, there can be no politi-
cal action.

U.S. Pharm PAC is alive, but not well around the Coun-
try. The profession needs the help that a PAC can give, but
we do not seem to be getting it going.

My own thoughts about how to remedy this situation
have been reinforced time and again when | observe other
PACs become organized and take off successfully. The
basis of the success of other PACs is their ability to sustain
a prolonged and repeated mail solicitation. This costs
money and our PAC has never had the requisite amount of
money. In short, we can't get started big until we have a big
amount to invest in fund raising. Naturally it would help if
all parts of our profession were pulling together in these
matters instead of pulling in different directions.

Pharmacy’s political problems are a mirror image of its
professional organizations goals and aspirations—these
are simply too many directions in a small profession.

Despite these obvious problems, we do have an impact
and | believe we will gain support from more and more
pharmacists each year. Please do your part to keep Mary-
land ahead.

William J. Skinner
General Counsel

SEPTEMBER, 1982

SELBY DRUG
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The new emblem for pharmacists utilizing the “P.D.” designa-
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these new insignia are embroidered in dark blue with a white
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
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650 W. Lombard St.
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13

Our best

friends are our
severest critics
and our greatest
assets.

Marilyn Slotfeldt, Pharm.D.
Clinical Services
Good Samaritan Hospital
Portland, Oregon

A

H. Joseph Schutte, R.Ph
Community Pharmacist
Louisville, Kentucky

Donald Hoscheit, R.Ph
Vice President, Pharmacy
Osco Drug, Inc
Oak Brook, Illinois

Louis M. Sesti, R.Ph
Executive Director
Michigan Pharmacists Association
Lansing, Michigan

Martin Lambert, Ph.D..R.Ph
Community Pharmacist
Knoxville, Tennessee

Stephen D. Roath, R.Ph
Vice President, Director of
Professional Affairs,
Longs Drug Stores, Inc
Walnut Creek, California

o

Harold H. Wolf, Ph.D.,.R.Ph
Dean, College of Pharmacy
University of Utah
Salt Lake City, Utah

Paul Burkhart, R.Ph
Director of Pharmacy
University of Maryland Hospital
Baltimore, Maryland

No diplomatic double talk.
We need the advice of
pharmacists in order to do
a better job for pharmacists.
The bad news and the good
That's what the ten mem-
bers of our 1982 Pharmacy
Consultant Panel provide
Their views on profes-

Harland W. Henry, R.Ph
Director of Pharmacy
Memorial Hospital System
Houston, Texas

Lawrence A. Diaz, R.Ph
Community Pharmacist
Gainesville, Florida

sional and other pertinent
matters are invaluable.

Their advice and coun-
sel helps us serve you bet-
ter in the expanding role
of pharmacy.

©1982. The Upjohn Company.
Kalamazoo, Michigan 49001

LETTERS

Dear Dave,

Will you express to the Maryland Pharmaceutical
Association our sincere thanks for the very beautiful
arrangement of flowers sent to us at the time of Vic’s
death? That is such a very lonely time and knowing that
Vic’s friends were thinking of us helped so very much.

I was most grateful for your letter concerning the
action taken at the Convention. Vic’s profession was as
central a part of his life as was his family and his faith.
His every action revolved around those three precious
things. It is most gratifying to know that he was so loved
by the men he respected so much. Please express my
thanks to them and my hope for a bright future for
Pharmacy in Maryland.

Sincerely
Frances L. Morgenroth

Dear Mr. Banta:

The Following is a continuing education conference
being conducted by the Medical College of Virginia,
School of Pharmacy:

‘‘The Pharmacist and Pain Management: New
Concepts in Pharmacotherapy of Pain”

Sunday, October 31, 1982

Saloia ie) Pil;

Fort Magruder Inn

Williamsburg, Virginia

CONTACT: Dr. Werner Lowenthal, Director
Continuing Education
School of Pharmacy
(804) 786-0334

Sincerely,
Werner Lowenthal, Ph.D.
Director, Continuing Education

Dear Mr. Banta:

At this late date, may the Executive officers, mem-
bers and staff of the Colorado Pharmacal Association
extend congratulations and best wishes in this your
centennial year.

Your accomplishments and contributions to this
profession have been many and varied and to have at-
tained this milestone must provide great satisfaction to
you and your members.

To have reached your goal of 1,000 members by
your centennial year is a great accomplishment and,
while the first 100 years are the hardest, they can also be
the proudest.

Arthur C. Hassan, Jr.
Executive Director

SEPTEMBER, 1982

Editors Note: This letter was read to the House of Delegates as they
considered a Resolution regarding the USP’s Dispensing Information.
The Resolution was tabled. See the August Issue for the Resolution.

Dear Dave:

I appreciate the high regard shown for USP DI by
the Association’s proposed resolution. Doubtless the
Association is aware that the original intent was to pub-
lish the Dispensing Information as a part of USP itself.
Protestations by national pharmacy organizations have
persuaded the USPC Board of Trustees to publish DI
separately thus far.

Be that as it may, the proposed resolution to elimi-
nate the requirement that pharmacies have on hand the
current USP and its supplements needs thorough and
thoughtful study before being presented to the Associa-
tion for a final recommendation. Timely as the proposal
may seem, giving up the presence of the Pharmacopeia
in pharmacies represents a loss of Power for Pharmacy.

Just how much loss and the possible ramifications
need study. The federal Food, Drug and Cosmetic Act
recognizes the USP standards of strength, quality, and
purity, and USP requirements for packaging and label-
ing; and the federal Food and Drug Administration is
authorized to enforce those determinations. Thus com-
pliance by the pharamacist would still be required and
presumably the conscientious or worried pharmacist
would buy the book even though the pharmacy was no
longer required to have it for its pharmacists.

The book itself, not the organization, is recognized
in the Law. It must be appreciated, however, that the
organization that writes the book is, although non-
governmental and biprofessional, in fact controlled by
Pharmacy (by sending a majority of the delegates and by
the power of the pocketbook). Thus any loss of prestige,
authority, or ubiquitousness by the USP is a loss to
Pharmacy. Although the ramifications might vary
somewhat from state to state, it is highly appropriate
that Maryland be the first to study the situation in rela-
tion to modern practices and requirements. It is, after
all, the state where USPC is headquartered and the
Chairman of the Board and the Executive Director both
are members of the Association.

I suggest that the proposed resolution be referred to
a MPhA committee that would look into the matter
thoroughly and come up with a recommendation next
year that would provide information useful to both
MPhA and USP. I or other members of the USP staff
stand ready to serve on the Committee, if requested, or
to serve as resource persons to the Committee.

I regret that I have meetings here this week that I
cannot get out of and will cause me to miss the MPhA
this year. I would appreciate your providing this letter
to the Resolutions Committee and extra copies are en-
closed for your convenience.

Sincerely,
William M. Heller
Executive Director

15

Your Peer Review Committee
in Action

This letter and response was read to the Association’s House of Delegates as an example of the kind of
activity the Peer Review Committee has generated. It was recommended that these letters be shared with
the membership with all identities obscured so that pharmacists will have a better understanding of both
sides of a typical consumer complaint received by the Committee.

Gentlemen:
I am writing to complain about a druggist,
, owner of _____ Pharmacy located at
Avenue.

My son was released from Church Home Hospital
on May 13 at 9:30 A.M. after back surgery for a slipped
disc. He was bedridden, unable to drive and in a great
deal of pain. A fellow roommate at his residence took a
prescription written by Dr. —_________. on Church
Home & Hospital prescription pads with the i.d.
number to a pharmacy in . When the room-
mate returned to the drug store he was informed they
didn’t have the drug needed. Unfortunately, half a day
had passed by the time this information was learned.
The roommate proceeded to Pharmacy
where upon Mr. advised that before he
could fill the prescription he would have to speak to the
doctor.

The roommate informed my son of this upon his
return home. My son called the druggist explaining how
much pain he was in and suggested that Mr.
contact the hospital where he could get a confirmation
of the authenticity of the prescription, since according
to Mr. , he had been unable to reach Dr.

. At this suggestion, Mr. hung up
on my son.

This is where I became involved in this fiasco. My
son’s roommate called me on my job very upset about
Mr. —__._ = 5 attitudes I petsonally vealledaMr
and was shocked to learn that my son and
his roommate were not exaggerating.

Mr. ________ would not answer my questions as
to why he wouldn't put forth some effort to contact Dr.

. Talking to Mr. was like talking
to a wall. In desperation I asked the druggist for his
name and at first he refused to tell me. I commented
“You are in business and you don’t want to tell me your
name?’’ Finally, with reluctance, Mr. iden-
tified himself.

! apologize for the length of this letter, but it is nec-
essary to give you the dialogue exchange in order that
you may determine how uncooperative and rude Mr.

was to me and my son.

I finally got Mr. to identify himself on
the phone and his next comment was ‘“‘I hope you are
satisfied.’> He also kept yelling ‘‘Have your son drive
down here and get the prescription and take it

16

elsewhere,’’ even though I had explained three times
that my son was unable to drive anywhere to pick up
anything. Mr. then said that he did not know
who my son was and couldn’t be sure that I was his
mother on the phone. It was finally obvious to me that
we were having a one-way conversation. Would you
believe Mr. hung up on me?

All of the above created an eleventh hour situation
for me since I cannot leave my job until 5:30 P.M. The
drug store closed at 6:00 P.M. and I had to retrieve the
unfilled prescription before the drug store closed in
hopes that I could get it filled elsewhere. I won’t elabo-
rate on my mad dash during rush hour traffic from my
job on Patapsco Avenue in Baltimore City to the drug
S{Ore ile ee

When I reached the drug store I was left standing at
the counter for at least three minutes before Mr.

even looked up to acknowledge my pres-
ence. It was at this point, for the first time, that the
druggist advised it was his policy not to fill a prescrip-
tion unless he spoke to the doctor personally. Needless
to say, I find that hard to believe.

My question to you is this. Doesn’t a pharmacist
have a moral obligation, responsibility or ethical sense
of duty to provide for a patient’s needs after he leaves a
hospital? Are we, the general public, to be at the mercy
of men like this who decide to play ‘*God?”’

My son experienced a great deal of pain his
first night home from the hospital thanks to Mr.
_____’s unreasonable, unsympathetic attitude, to
say nothing of his neglect and lack of common sense and
compassion.

Needless to say, my son, nor I will ever do business
with the Pharmacy again. Unfortunately,
Mr. __________ will continue to inflict his own brand of
torture on the unsuspecting public.

I would certainly appreciate any type of reprimand
you could give to Mr. . A friend of mine who
owns a business in the area advised me not
to waste my time writing letters complaining about Mr.
_.__.__-.. Since, as he put it, “He ownsshaieeae

. Is this, then, to be another case of the
‘little guy’ getting stepped on by those in power?

Very truly yours,

CC: Maryland Board of Pharmacy Licensing
Matt Seiden—The Sun

THE MARYLAND PHARMACIST

The Committee’s

Response

Dear é

We were sorry to hear about the unfortunate diffi-
culty your son had in trying to get a prescription filled.

We in the pharmacy have always been concerned
that such an incident would occur, and I would like to
explain why it did happen.

Pharmacists have been plagued with armed holdups,
break-ins and forged prescriptions by individuals
searching for narcotics. In addition, they have been
prosecuted for filling narcotic prescriptions that have not
been properly authenticated by the prescribing doctor.

According to Dr. , your son had a pre-
scription for Tylox, a narcotic, written on a hospital
blank, which is a notorious source for forged narcotic
prescription. The prescription was presented to the
pharmacist by a youth who had arrived on a motorcy-
cle, who admitted that the prescription was not for him.

The pharmacist had told your son on the phone that
he had the drug, but would not fill the prescription until
its authenticity was confirmed. Dr. called
the hospital and was told that Dr. was not
there. He then called another number which the hospital
personnel gave him, but was still unable to reach Dr.

This explains the dilemma that the pharmacist was
in. We can not condone any rudeness on his part, but it
was a legitimate judgement call.

The pharmacist’s livelihood depends on filling pre-
scription; he loses time and money when he does not fill
the prescription. Like most pharmacists Dr.
was doing what he thought was in the best interest of the
public.

To avoid any future problems, we would suggest
that you patronize one pharmacy; one that maintains a
family record file. With such a record, your pharmacist
would know each individual and be aware of his com-
plete drug history.

Thank you for your informative letter, it makes us
more aware of the viewpoint of an innocent victim of
our complex modern society.

Sincerely,

Irvin Kamentz, P.D.

Chairman, Peer Review Committee
Maryland Pharmaceutical Association

SEPTEMBER, 1982

Irvin Kamenetz, Chairman of the Peer Review Committee reviews
the work of the Committee over the past year and shared with the
House of Delegates a typical letter of complaint and the Com-
mittee’s response.

What business
does a handsome dog
like me have
é witha

My name’s McGruff, and it’s
my business to help prevent
crime. I think it should be your
business, too—to teach your
employees how to protect them-
selves. Just send for my busi-
ness kit—it’ll help you develop

a program that teaches your
employees how to make their
homes burglar-proof, make their
neighborhoods safer, even how
not to get mugged.

So take the time, and...

TAKE A BITE OUT OF

CRIME

Write to McGruff, Crime Prevention Coalition,
20 Banta Place, Hackensack, NJ 07601 for
lots of information on Crime Prevention.

A message from the Crime Prevention Coalition,
4V@§ this publication and The Ad Council.
Cou Chi

©1980 The Advertising Council, Inc

IZ

SISG6F
Pharmacy
Support

I

Are you taking advantage of all the
proven methods to promote a phar-
macy's prescription department?

If not, SK&F’s newest 30-minute video-
tape program can start you thinking
about the opportunities you may be
Missing.

Our new management program is called
Promoting Your Prescription Depart-
ment—and it’s designed as a seminar
for interested groups of community
pharmacists.

You can learn more about adverising,
promotional budgets, personal selling,
publicity, pharmacy layout, and evalua-
tion of your promotion efforts.

ZS és Pelt

ARE YOU
“SELLING”
YOUR
PRESCRIPTION
DEPARTMENT ?

Promoting Your Prescription Depart-
ment is one more valuable addition to
the pharmacy management series now
available from SK&F.

Ask your SK&F Representative how you
can obtain this videotape program for
your next meeting.

©SmithKline Corporation, 1982

SIXGF

a SmithKline company

Smith Kline &French Laboratories
Philadelphia, Pa

THE MARYLAND PHARMACIST

When

was the

last time
your
insurance
agent

gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville, Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
ANTHONY G. PADUSSIS EVERY YEAR!
Usually for more than 20% of his premium.

TONY is one of the many Maryland pharmacists —
participating in the Mayer and Steinberg/

MPhA Workmen's Compensation Program—
underwritten by American Druggists

Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENeS
call or write:

Your American Druggists’ Insurance Co. Rebrosentalne ‘

AMERICAN
Anco DRUGGISTS’
INSURANCE

Please contact me. | am interested in receiving more

information about the Mayer and Steinberg/MPhA Workmen's

Compensation Program. O Call O Write

American Society of Consultant Pharmacists

ASCP’s Statement to the
APhA Task Force on
Pharmacy Education

by Jerome L. Fine, M.S., P.D., FASCP, ASCP President

Jerry Fine is President of the American Society of Consultant Pharmacists and a member of the Maryland
Pharmaceutical Association. He delivered these remarks to the Task Force on Education at the APhA

Convention in Las Vegas.

The practice of pharmacy in the United States con-
tinues to change at a rapid pace. Some practitioners,
academicians, and other pharmacy leaders maintain that
this change is evolutionary while others claim that it is
almost revolutionary. For varying reasons, however, most
do agree with the assertion that pharmacy education has
not responded to these changes in the most appropriate
fashion.

Certain changes in pharmacy practice have been pre-
cipitated by the profession’s desire and efforts to expand
its role and recognition in the delivery of health care ser-
vices. Other changes, however, have been forced on the
profession through external factors. Both internal and ex-
ternal pressures that have and will continue to alter the
manner and scope of pharmacy practice must be well rec-
ognized and understood by those responsible for devel-
oping and executing the pharmacy education process.
This is critical in order to produce graduates that can re-
spond to today’s dynamic practice and meet the future
needs of the profession.

One of the external factors affecting pharmacy today is
this country’s growing numbers and proportion of elderly
individuals. This shift in the age of the population has only
begun to receive adequate attention by our colleges of
pharmacy.

By the year 2000, demographers predict a 33% increase
in the number of individuals 65 years and older. By then we
will have more than 32 million elderly that, as a group,
suffer from numerous chronic illnesses and take consider-
able amounts of medications. The drug consumption pat-
terns of the elderly along with their altered physiologic
responses to these drugs create a requirement and op-
portunity for extensive and special pharmacy services.

Pharmacy students are not being appropriately pre-
pared to provide these special services to this population
segment. Today and in the future, pharmacy schools must
devote concentrated effort to assure that pharmacists fully
understand the physiology, the prevalent pathologies and
related drug therapy, and the psycho-social aspects of
growing old.

Concurrent with this confirmed increase in the elderly
population, we will experience a continued expansion in
the number of long term care facilities in this country.

20

Nursing homes and other similar care settings will be nec-
essary to provide shelter and a wide variety of health care
and other social services to this population group.

Even today, the number of patients cared for in nursing
homes (1.4 million) exceeds our country’s acute hospital
capacity (1.2 million). In the future, the difference in pa-
tient counts will grow as the actual number of acute hos-
pitals continues to decline.

Over the last decade, the role of the pharmacist in the
long term care setting has broadened dramatically. Once
thought of only as ‘hospital pharmacist’ functions, to-
day’s long term care pharmacy practitioner routinely pro-
vides extensive drug therapy assessment activities, in-
novative drug distribution systems, unique administrative
and clinical consultant services, policy and procedure de-
velopment, in-service education programs, and cost-
effective computer services.

Even though long term care presents pharmacy with
the fastest growing opportunity for professional practice,
the specialized area of practice has been largely ignored
by our colleges of pharmacy. This fact is evidenced by the
lack of clinical rotations of pharmacy students through
nursing homes, by the lack of required courses that focus
on the medical, social, and pharmacotherapeutic prob-
lems of the elderly, and further by the lack of development
of long term care pharmacy residency programs. Many
colleges have also failed to offer good post-graduate con-
tinuing education programs specifically directed toward
nursing home practice.

Colleges must recognize the critical impact that phar-
macists can make in the nursing home setting and begin
immediately to develop under-graduate and post-graduate
education programs that meet the information needs that
currently exist.

As pharmacists have emerged from behind the pre-
scription counter, a significant weakness in their educa-
tional background has become apparent. This weakness is
the ability to communicate effectively with the public. In
order to adequately counsel patients on drug therapy,
pharmacists must be thoroughly skilled in all aspects of
communication, both talking and listening.

The importance of the skill transcends simply talking
to patients and includes various forms of interaction with

THE MARYLAND PHARMACIST

other health professions. For example, the value of an ef-
fective patient drug regimen review is lost when the phar-
macist cannot appropriately communicate his or her rec-
ommendations for improvements in that therapy to the
physician. Further, all the pharmacist’s drug education is
almost meaningless if he or she cannot act as the expert in
providing education programs for other health profes-
sionals such as nurses.

Communication skills will become more and more im-
portant to the pharmacist as the degree of patient orienta-
tion in the professional practice increases. The proportion
of time pharmacists will spend handling drug products in
relationship to dispensing activities has already and will
continue to diminish. This decrease in the mechanical
functions of the pharmacist is motivated by any number of
factors including the advent of technology such as com-
puters and tablet counters as well as increases in the
number of unit of use packaged drug products. Addition-
ally, the simple economic reality that supportive personnel
allow the pharmacist to be more productive is a strong
factor in freeing the pharmacist for more patient oriented
services.

These factors combined with the demands of the public
and the desires of the profession, give pharmacists more
time and opportunity to be directly involved with the pa-
tient and more need to rely on his or her ability to com-
municate with individuals.

Another almost universally acknowledged inadequacy
in today’s pharmacy curriculum is the broad area of busi-
ness and management. Today’s pharmacy graduates are
entering practice ill-prepared to deal with the sophisti-
cated business environment that exists irrespective of the
practice setting. It matters not whether the graduate
chooses independent, chain, hospital, industry, or long
term care pharmacy, the need for comprehending the ba-
sics of accounting, finance, personnel management, and
other business skills exists.

Belaboring this point is not necessary, but a couple
examples are illustrative. In long term care pharmacy our
membership surveys indicate that almost 60% of the Soci-
ety’s members utilize computers. Obviously, a newly hired
pharmacist will be totally lost and unproductive if his edu-
cational background only included a typical dispensing
laboratory and lacked exposure to computerized prescrip-
tion processing procedures.

Another example relates to personnel management
skills. With the increasing utilization of supportive person-
nel in all practice settings it is likely that even a newly hired
pharmacist will have some degree of supervisory respon-
sibility over these individuals. Without at least rudimentary
supervisory skills, that newly hired pharmacist could easily
find that he or she is soon grouped by upper management
with those supportive individuals.

Another current development in pharmacy practice
that has received scant attention by our schools of phar-
macy is the increasing numbers of pharmacists that are
involved in providing consultant services. These services
are being provided to a wide variety of health care settings
including home health care agencies, community health
care centers, prisons and jails, industrial plants, and hos-
pice organizations among others. The non-dispensing ser-
vices offered range from simple drug therapy in-service
programs to in-depth drug therapy assessment and coun-
seling to recommendations on drug handling procedures.

Surveys of ASCP’s membership indicate that almost
40% of Society members are providing consultant services
to an organization or institution other than a long term
care facility or hospital. This further expansion in the role
of the pharmacist highlights the fact that pharmacists have
expertise that is valuable in and of itself.

SEPTEMBER, 1982

Although our colleges could not be expected to pre-
pare recent graduates to function as expert consultants, it
is important, however, that pharmacy students be exposed
to the fact that this type of career opportunity is available.

Another issue that cries for immediate attention from
our colleges is final resolution of the nature and title of the
degree awarded as the initial entry level degree for phar-
macy. The current two level degree approach has caused
considerable confusion, discension, and anger in the
profession and among the public. Adoption of a consistent
and single pharmacy entry level degree should be as-
signed priority by the colleges and the profession.

The diversity of professional pharmacy practice today
presents a true dilemma for our colleges in preparing
graduates to enter and succeed in the profession. The fact,
however, that the profession has attained its current high
level and scope of practice attests to the colleges’ ability to
respond to change and to plan for the future.

The American Society of Consultant Pharmacists ap-
preciates this opportunity to offer our comments to the
Task Force on Pharmacy Education.

MURPHY’S
NEWEST SET OF LAWS

. There’s always one more bug.

. Build a system that even a fool can use,
and only a fool will use it.

. The reliability of machinery is inversely
proportional to the number and signifi-
cance of any persons watching it.

. It works better if you plug it in.

. If it jams—force it. If it breaks, it needed
replacing anyway.

. When all else fails, read the instructions.

. It won’t work.

. If enough data is collected, anything may
be proved by statistical methods.

. When working toward the solution of a
problem, it always helps if you know the
answer.

. All great discoveries are made by mis-
take.

. The greater the funding, the longer it
takes to make the mistake.

. The progress of science varies inversely
with the number of journals published.

. There’s never time to do it right, but
there’s always time to do it over.

. The man who can smile when things go
wrong has thought of someone he can
blame it on.

. An expert is a person who avoids the
small errors while sweeping on to the
grand fallacy.

. Never sleep with anyone crazier than
yourself.

. Men and nations will act rationally when
all other possibilities have been
exhausted.

Piroxicam (Feldene ), A Review

by J.Lysle Hendrix, M.S., R.Ph.
Senior Pharmacist

Department of Pharmacy
University of Alabama Hospitals
and Clinics

Piroxicam (Feldene®, Pfizer Lab-
oratories) is the first of the
‘‘oxicams’’—a new family of non-
steroidal anti-inflammatory agents.
Piroxicam is a unique compound, chem-
ically unrelated to the other non-
steroidal, anti-inflammatory drugs.

8

In clinical evaluation, piroxicam
has shown anti-inflammatory, analgesic
and antipyretic properties in clinical and
animal test systems. Its mechanism of
action, like that of other nonsteroidal
anti-inflammatory agents, is not com-
pletely known. However, a common
mechanism may exist in the ability of
piroxicam to inhibit the biosynthesis of
prostaglandins.

Animal studies have shown pirox-
icam’s anti-inflammatory activity to be
twice as potent (weight-for-weight) as
that of indomethacin, 7 times as potent
as that of naproxen, and 14 times as po-
tent as that of phenylbutazone. Anti-
inflammatory activity was also demon-
strated against: adjuvant-induced ar-
thritis and granuloma tissue formation
in rats; urate crystal-induced synovitis
in dogs; and_ ultraviolet-induced
erythema in guinea pigs. (Piroxicam, at
doses one-tenth those of aspirin,
displayed potent analgesic activity in
irritant-induced pain in the mouse to a
similar extent as that of aspirin.) Pirox-
icam was also effective in elevating the
pressure threshold in the edematous
hind paw of rats. In oral doses of 10
mg/kg, piroxicam was as effective as 56
mg/kg of aspirin in inhibiting pyrexia
induced by intramuscular injection of
E. coli.

In man, piroxicam is well absorbed
following oral administration. Drug
plasma concentrations are proportional
to the doses given for 10 mg and 20 mg
doses. They generally peak within five
hours after medication, and subsequent-
ly decline with a mean half-life of 50
hours.

This results in the maintenance of
relatively stable plasma concentrations
throughout the day on once-daily doses.

A single 20-mg dose generally produces
peak piroxicam plasma levels of 1.5 to 2
mcg/ml, while plasma concentrations,
after repeated daily ingestion of 20 mg
piroxicam, usually stabilize at 3-8
mcg/ml. Most patients approximate
steady state plasma levels within 7 to 12
days. Higher levels, which approximate
steady state at two to three weeks, have
been observed in patients in whom long-
er plasma half-lives of piroxicam oc-
curred.

Studies show that in man piroxicam
is extensively metabolized by the liver.
Very little is excreted unchanged, with
daily excretion reported at less than 5%.
Metabolism occurs by hydroxylation at
the 5 position of the pyridyl side chain
and conjugation of this product; by
cyclodehydration; and by a sequence of
reactions involving hydrolysis of the
amide linkage, decarboxylation, ring
contraction, and N-demethylation. As
would be expected from a drug for
which renal excretion is only a minor
route of elimination, patients with mild
to moderate renal impairment have es-
sentially normal pharmacokinetics with
piroxicam. As with other prostaglandin
synthesis inhibitors, reversible eleva-
tions of BUN have been reported.

Clinical studies have confirmed
piroxicam’s analgesic, antipyretic and
anti-inflammatory properties observed
in animal studies. Additionally, several
studies have been done which compare
piroxicam with other drug therapies.
When compared with salicylates in
maximally tolerated doses, piroxicam
20 mg daily produced comparable
improvements in all measured para-
meters with less troublesome side ef-
fects. In patients with osteoarthritis the
use of piroxicam 20 mg daily was found
to be more effective in relieving
pain and in improving mobility than the
use of aspirin in daily doses of 2.6 g
to3.9g.

Several studies have also compared
piroxicam with other nonsteroidal, anti-
inflammatory agents. When compared
with naproxen 250 mg b.i.d., piroxicam
20 mg daily was significantly more
effective in reducing pain at rest, pain at
night and pain on motion. Also, those
patients taking piroxicam showed ad-
vantages in measurements of general ac-
tivity and overall assessment. In a study
which compared piroxicam and indo-
methacin, one daily dose of piroxicam
(20 mg) and high doses of indomethacin
(100-200 mg) were both found to be ef-
fective in reducing the inflammatory
signs of rheumatoid arthritis. However,
in the same study, piroxicam showed
advantages in decreasing the duration of

morning stiffness and the number of
joints painful on motion.

A key finding in all crossover
studies and several open studies has
been a strong patient and physician
preference for piroxicam over other
NSAI drugs. For example, in one study
involving 749 patients conducted by 156
physicians, the physicians rated pirox-
icam as better than their patients’
previous therapy in 72% of the cases.

Piroxicam is indicated for acute
and long-term use in the treatment of
both rheumatoid arthritis and osteoar-
thritis. It is contraindicated in patients
who have previously exhibited hyper-
sensitivity to it, or in individuals with
the syndrome of nasal polyps, angio-
edema, and bronchospastic reactivity to
aspirin or other anti-inflammatory
agents.

As with other nonsteroidal anti-
inflammatory agents, the most fre-
quently reported side effects are gastro-
intestinal, occurring in approximately
20% of patients. In most instances,
these effects were in the mild-to-
moderate range and did not interfere
with the course of therapy. This com-
pares favorably with other nonsteroidal,
anti-inflammatory agents: piroxicam
generally has had fewer adverse effects
than indomethacin, phenylbutazone or
aspirin and was comparable to
ibuprofen and naproxen.

Of the patients experiencing gastro-
intestinal side effects, approximately
5% discontinued therapy with an
overall incidence of peptic ulceration of
about 1%.

Piroxicam is highly protein bound
and, therefore, might be expected to dis-
place other protein-bound drugs. Al-
though in vitro studies have shown this
not to occur with dicoumarol, patients
taking coumarin-type anticoagulants
and other highly protein-bound drugs
should be closely monitored when
piroxicam is also taken.

The concomitant use of piroxicam
and aspirin is not recommended.
Plasma levels of piroxicam are de-
pressed to approximately 80% of their
normal values when piroxicam is ad-
ministered in conjunction with aspirin
(3900 mg/day). However, plasma con-
centrations of piroxicam do not appear
to be significantly influenced by con-
comitant administration of antacids.

It is recommended that piroxicam
therapy should be initiated and main-
tained as a single daily dose of 20 mg. If
desired, the dose may be split and given
twice daily. Dosage recommendations
and indications for use in children have
not been established.

a
Entertainment at a Convention Cocktail Party was provided by
(left to right) Stan Brown, President of the Prince Georges/Mont-
gomery County Pharmaceutical Association; Paul Freiman, — ,
Secretary of the Board of Pharmacy; and Dave Banta, MPhA MPhA Past President Phil Cogan literally wore his professiona!
Executive Director. occupation on his shirt at the Annual Convention Crab Feast.

J,

Alumni Association President Angelo Voxakis addressed the fu-

Alumni Association, delivers remarks to the Alumni Association ture of the profession for the graduating pharmacy students at
Annual Graduation Banquet. the banquet held May 27, 1982, in Baltimore.

This donated b
cco ce ee Y Pictures courtesy Abe Bloom — District Photo

Photo Service.

10501 Rhode Island Avenue Gap
Beltsville, Maryland 20705 ta a.

In Washington, 937-5300
in Baltimore, 792-7740

SEPTEMBER, 1982 PE:

BOBHAAN

WN OY MO YY CAN

MRAM an

OO DM DO ODM OOM MV 9

\ MBHOBHA Ws

; NOTICE

Maryland State Law will Not
Allow Pharmacies
to accept medications back
for resale.... This law

protects you from receiving
medication which has been out of
the pharmacists control and may

be subpotent due to
exposure to heat and humidity.

This information is provided by a concerned health care pro-
fessional, Your Community Pharmacist, a member of the Mary-
land Pharmaceutical Association.

THE MARYLAND PHARMACIST

NOTICE

Clin anc

Telephone Numbers

Industry Relations Committee Project

Listing of Product Information Telephone Numbers for drug manufacturing companies. Compiled by the Industry
Relations Committee.

Abbott (312) 937-6100 Norwich-Eaton Pharmaceuticals (607) 335-2550
Alcon Laboratories (817) 293-0450 Organon Pharmaceuticals 800 631-1253 (toll free)
Allergan (714) 752-4500 Ortho Pharmaceutical 800 631-5273 (toll free)
American Critical Care 800 323-4980 (toll free) Pennwalt (716) 475-9000
B. F. Ascher (913) 888-1880 Pfizer Labs (212) 573-7348
Beecham 800 251-0271 (toll free) Pfipharmecs (212) 573-7415
Becton Dickinson (201) 368-7300 (212) 573-2242 (Night Emergency)
Berlex Labs (201) 540-8700 Reed and Carnrick (201) 981-0070
(609) 921-1707 (Medical Emergencies) A. H. Robins (804) 257-2563
Bristol Laboratories (315) 432-2000 Roche Laboratories (201) 235-5000
Burroughs Wellcome Co. (919) 5412-9090 Roerig (215) 573-3288
Endo 800 441-7516 (toll free) Roxane 800 848-0120 (toll free)
Geigy Pharmaceuticals (201) 277-5000 Sandoz (201) 386-7913
Hoechst-Roussel (201) 231-2611 Savage (713) 499-4547
Hyland Therapeutics 800 423-2090 (toll free) Schering (201) 558-4000
Hynson, Wescott and Dunning 800 638-1532 (toll free) Searle Labs 800 323-4397 (toll free)
Knoll Pharmaceuticals 800 526-0221 (toll free) Smith, Kline and French (215) 751-4740 (can call collect)
Lederle Labs 800 523-6610 (toll free) Stuart Pharmaceuticals 800 441-7758 (toll free)

Eli Lilly and Co. (317) 261-2339 (Technical Questions) E. R. Squibb 800 631-5244 (toll free)
(317) 261-3714 (Medical Information) Syntex 800 227-8416 (toll free)
(317) 261-2000 (Emergency Information) Upjohn 800 424-3640 (toll free)

McNeil Pharmaceutical (215) 628-5000 USV Labs (914) 631-8500
Mallinckrodt 800 325-8181 (toll free) Warner Lambert (201) 540-4371
Mead Johnson (201) 881-7500 Winthrop 800 223-1062 (toll free)
Merck Sharp and Dohme (215) 661-7300 Wyeth (215) 688-4400

Miles (219) 264-8645

UPDATE THYSELF.

i

Cun Pawicer Advice for the Pasent

ao
ood
<

The United States Pharmacopeia keeps you up-to-date Volume | is the pharmacist’s guide to over 4,500 drug
with the 1983 USP Dispensing Information (USP Dl)—a dosage forms and brands. Volume II is a corresponding lay
newly expanded and updated edition, available for the first language guide for patients, designed for use as a patient ed-
time as a two-volume set. ucation tool. To order your copies, just mail in the coupon below.

Fh tnd cal pel loa agp lech ple mn pre melee rtm lol ren bel oo eh ataataees

Please send me the following: MAIL TO: Maryland Pharmaceutical Association
Quantity 650 W. Lombard Street
1983 USP DI, each complete two-volume set, $37.95. * Bamore Maryland a2 120
Additional copies of USP D/ Volume ||, Advice for the Patient, at $17.95* each.
About Your Medicines Consumer Display Kit (12 lay language paperback books packaged in counter-top display
box), $36.00. (Suggested retail price $4.95.)
1980 USP XX - NFXV, $75.00* *; or $100.00* * with annual supplements.
Free Patient Education Program Promotion Kit.
Total Cost $=. Enclosed is my check or money order for$___ ~—=~—~——SS—spayable to USP, or charge my order to:

OVISA O MASTERCARD Account Number: J LILI OOOO OUODODOODOUD OO
Expiration Date: Signature:
SEND TO: ADDRESS:
fay see en eee gee ree CSTATE: ZIP:

*Maryland residents add 5% sales tax. **Pennsylvania residents add 6% sales tax. 1983 USP Dis will be shipped in July 1982.

SS A NS SE OS
a GAR GA GES GS A RE a Gs a

Art Prints Available
Maryland Pharmacy History

The Centennial Committee of the Association has commissioned a limited set of art prints depicting
historical sites in Maryland. These prints by noted artist Marian Quinn are each hand numbered and
signed by the artist. The prints are available from the Association Office at $7.50 each or four for
$25.00. They are ink line drawings that are certain to be collectors items in the future.

E.W. STERLING PHARMACY, CHURCH HILL, MO
BU

ILT IN 1895

: 1
§ (Order Form) art print order form |
| |
Ly i
r] Name |
we) 2Add ;
a ress i
2 H
g 4
3 Phone '
i 4
i Number of Prints at $ is $ Total enclosed i
i 4
i i
B (Prints are $7.50 each or four for $25.00) i
Mail this form and check made payable to MPhA to 650 West Lombard St., Baltimore, Maryland ;
21201.
3 |

Do you know how to prepare for a third-party audit? What
your rights are? How to evaluate third-party contracts?
Are you considering participating in a_ third-party
program?

The Manager’s Guide to Third-Party Programs goes to the

heart of these issues and other problems faced by the pharma-
cy manager coping with the reality of third-party programs.

It's more than a survival kit—it’s a prescription for effective
management!

Thoroughly researched,
simply written and filled with
practical information, the
100-page soft cover book
provides step-by-step guid-
ance, background and refer-
ence material.

Written by Joseph L. Fink Ill,
a nationally known pharma-
cist and lawyer, in collabora-
tion with APhA’s Pharmacy
Management Institute, it’s a
must for any pharmacist’s
library.

Order now while supplies last.

Order Desk, Dept. S

American Pharmaceutical Association
2215 Constitution Avenue, N.W.
Washington, DC 20037

(202) 628-4410

Manager’s Guide to Third-Party Programs
$18 ($12 for APhA Members),
S9 per copy of orders of 100 or more

Please send me ______ copies atS ______ each.

Name

Address

City

Eat Hl (i ee Se ee Pere ee rere es os 2 Zip

All orders totaling less than $200 and all foreign orders must be prepaid. For-
eign orders add 20% for postage and handling. To receive the member rate,
attach your mailing label from an APhA publication

820721

Third-Party Woes?

° wy
manent

hd

Contents

APhA and Third-Party Programs:
A Statement of Principle and

Intent

Foreword

Introduction

Evaluating the Practice
Preliminary Considerations
Economic Analysis

An Analytic Checklist

Methods of Effective Participation
A Decision to Discontinue

Evaluating the Contract

Level of Reimbursement
Subscriber Cost-Sharing
Claim Forms

Beneficiary Identification
Auditing of Pharmacy Records
Exclusions from Coverage
Other Provisions

Contract Termination
Conclusion

Auditing Activities Under
the Program
Guidelines for Audits

Sample Contract
Glossary

Supplementary Sources

of Information

General

Audits

Capitation

Confidentiality of Patient
Information

Drug Coverage Under National
Health Insurance

Legal Issues

Medicare and Medicaid

Third-Party Program Coverage

Third-Party Program Guidelines

Reimbursement

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

DANTROLENE:

Dantrolene (Dantrium) is a skeletal muscle relaxant
that works in the skeletal muscle tissue itself by inter-
fering with the excitation-coupling reaction. Since mus-
cle activity is altered, it was suggested that its ability to
decrease contractility might allow it to be an effective
antiarrhythmic agent. Experiments conducted in iso-
lated canine cardiac tissue indicate that this drug is ca-
pable of decreasing the contractility of cardiac tissue. It
seems to mimic some action of verapamil and thus may
have some value as an antiarrhythmic agent. J Phar-
macol Exp Ther, Vol. 220, #1, p. 157, 1982.

PHENYTOIN-VALPROATE INTERACTION:

Sodium valproate (Depekene) is often used along
with phenytoin (Dilantin) to control convulsive disor-
ders not regulated by phenytoin itself. Valproate dis-
places phenytoin from binding sites on plasma pro-
tein and thus the plasma concentrations of the an-
ticonvulsant will not accurately reflect its activity
level since a higher proportion of the drug will be in the
free, unbound active form. Studies conducted in 42 vol-
unteers indicate that although plasma values of phenyt-
oin are not valid indicators of the drug’s effectiveness
under these conditions, saliva samples do not vary with
valproate administration and thus are preferred to
plasma samples while monitoring phenytoin levels in
patients receiving valproate. Br Med J, Vol. 284, #6308,
Duis selene

METOPROLOL WITHDRAWAL:

Patients were maintained on metoprolol (Lopressor)
at doses of 50 mg twice daily for six weeks and then the
drug was withdrawn and replaced with a placebo prepa-
ration. All patients experienced an increased sensitivity
to isoproterenol (Isuprel) and a 15% rebound rise in
resting heart rate. Discontinuing the medication gradu-
ally (SO mg once daily for ten days) helped decrease the
sensitivity to the adrenergic agent, but did not com-
pletely abolish it. The increased sensitivity may be due
to an increase in receptor density which may occur in
response to beta-adrenergic blockage. Clin Pharmacol
Ther, Vol. 31, #1, p. 8, 1982.

PATIENT CONTROLLED ANALGESIA:
Patient-controlled analgesia (PCA) is a technique
which allows a patient requiring constant narcotic
analgesic therapy to titrate their own dosage as neces-
sary. Patients have a device which can be activated as
needed to supply a dose of the narcotic through an in-
travenous tubing. Initial results suggest that the patient
using this device can regulate their analgesia without

28

producing excessive side-effects, including drowsiness.
These patients are also thought to have a reduced likeli-
hood of becoming dependent on the narcotics. J Am
Med Assoc, Vol. 247, #7, p. 945, 1982.

RAYNAUDS PHENOMENON:

A vasospasm of digital vessels may result in sensa-
tions of coldness in the hands known as Raynauds phe-
nomenon. Captopril (Capoten) is a converting enzyme
inhibitor used primarily to treat high renin hyperten-
sion, but recently it was found to also be effective in
relieving the discomfort of Raynauds phenomenon.
Since this alteration in temperature perception is not
thought to be associated with excessive angiotensin II
activity, it has been suggested that captopril exerts its
beneficial effect by allowing for the accumulation of cir-
culating kinins. The kinins produce vasodilation and in-
crease perfusion through the extremity. Br Med J, Vol.
284, #6312, p. 312, 1982.

BODY FAT DISTRIBUTION:

The distribution of body fat above and below the
waist may indicate the likelihood of diabetes mellitus
development in women. Women who have more fat
above the waist are more likely to have problems with
carbohydrate intolerance than are those whose fat de-
posits are primarily in the hips, thighs, and buttocks.
The fat cells in the lower part of the body have normal
characteristics while those obtained from above the
waist are generally enlarged, engorged with fat, and
have a lower insulin receptor density. J Am Med Assoc,
Vol. 247, #6, p. 731, 1982.

PROPRANOLOL DOSING:

Propranolol (Inderal) has been said to produce sus-
tained beta-adrenergic blockade but only if given in four
daily doses. In order to test this observation, the drug
was used in doses of 80 mg twice daily or 40 mg four
times daily. The plasma levels of 19 volunteers were
monitored and after seven days of therapy it was con-
cluded that the relative rate and extent of propranolol
absorption was greatest after the twice-daily dosing
schedule. In addition, the use of the drug in two daily
doses also produced smaller variations in ‘‘area under
the curve” calculations. Clinical studies will now follow
to determine if patients requiring sustained beta ad-
renergic blockade can use propranolol in this manner. J
Clin Pharmacol, Vol. 21, #11, p. 472, 1981.

THE MARYLAND PHARMACIST

1981 PRESCRIPTION AUDIT:

During 1981, Merck, Sharpe and Dohme and Smith,
Kline and French Companies were the leaders in retail
prescription sales volume. The drugs most often pre-
scribed were Tagamet, Inderal, Valium, Motrin,
Dyazide, Keflex, Clinoril, Aldomet, Naprosyn, and
Lasix. FDC Rep, Vol. 44, #4, p. 6, 1982.

CAFFEINE AND ALCOHOL:

The intoxicating effects of ethanol have often been
treated with coffee or other caffeine-containing bever-
ages. A group of volunteers consumed a known amount
of ethanol which was followed by a battery of
psychophysical tests. They were then given either reg-
ular or decaffeinated coffee to drink and the tests were
readministered. No evidence was found to support the
concept that coffee or caffeine-containing beverages
helped to counter the inebriation produced by ethanol.
Clin Pharmacol Ther, Vol. 31, #1, p. 68, 1982.

DIURETIC THERAPY:

Hypokalemia can be a complication of thiazide ther-
apy. Since the diuretics are often considered the drug of
choice for mild hypertensive conditions, concern has
been expressed that drug-induced hypokalemia might
be more common than anticipated. Some drugs in this
class have a longer duration of diuretic action than
others, but evidence seems to indicate that the
antihypertensive activity of these diuretics exceeds that
of the diuretic response and probably lasts 24 hours
regardless of the agent used. Experiments using hyd-
rochlorothiazide (short diuretic action) and chlor-
thalidone (long diuretic action) indicate that the degree
and incidence of hypokalemia is greater with the long
acting drugs. It seems that small doses of short acting
diuretics are the preferred treatment for mild hyperten-
sion. Clin Ther, Vol. 4, #4, p. 308, 1981.

LAETRILE:

Laetrile proponents have said the reason the sub-
stance is not always capable of exerting its ‘‘anti-
cancer’ effect was due to the fact that physicians
waited until the disease reached an advanced stage be-
fore the drug was used. It has been suggested that laet-
rile (Amygdalin) may also be best used to prevent
cancer. A study involving 187 patients with cancer indi-
cated that no benefit was derived from laetrile therapy,
even when accompanied by the recommended ‘‘meta-
bolic’’ therapy consisting of diet, enzymes, and vita-
mins. Patients in the study were in good general health
prior to start of therapy. No improvement or stabiliza-
tion of neoplastic growth was noted in any patients re-
ceiving the regimen. The drug did produce symptoms of
cyanide toxicity in several patients. Thus one more sci-
entifically designed prospective study has failed to show
benefit from laetrile administration. A growing body of
clinicians feel that no benefit will be derived from this
therapy. N Engl J Med, Vol. 306, #4, p. 201, 1982.

SEPTEMBER, 1982

DMSO:

Dimethylsulfoxide (DMSO) is often used in a non-
approved way to treat rheumatoid arthritis. The drug
sulindac (Clinoril) is also used to help alleviate rheu-
matic pain so it is not surprising to find that some pa-
tients will use both drugs concomitantly. Sulindac is not
active in itself, but must be converted into the active
metabolite by enzymatic action. DMSO apparently in-
hibits the reduction of sulindac to its active component
and thus interferes with its efficacy. Patients using
sulindac should be cautioned to avoid DMSO. Drug
Metab Dispos, Vol. 9, #6, p. 499, 1981.

SALICYLATE:

Many actions of the salicylates are due to the ability
of the compound to inhibit cyclo oxygenase enzyme
activity and thus decrease the synthesis of prostaglan-
dins. Experiments were designed to determine if the
activity on this enzyme resulted in the salicylate-
induced enhancement of respiratory activity which is
noted when the analgesic is ingested in large doses. Al-
though salicylates did increase the respiration routinely
in experimental models, other inhibitors of prostaglan-
din synthesis (e.g. indomethacin) had no such activity.
The salicylate-induced effect is probably due to hyper-
metabolism of the respiratory regulatory tissue. J
Pharmacol Exp Ther, Vol. 219, #3, p. 723, 1981.

ACETAZOLAMIDE:

Acetazolamide (Diamox) is used in treating wide
angle glaucoma, frequently on a long-term basis. The
drug initially causes a loss of bicarbonate in the urine
which subsequently produces a mild form of metabolic
acidosis. Practitioners are cautioned to use acetazol-
amide with care in patients who have reduced renal
function, especially the elderly. These people have an
increased likelihood of developing systemic acidosis
and may display the consequences associated with that
imbalance.’Br Med J, Vol. 283, #6305, p. 1527, 1981.

LEVOTHYROXINE:

Thyroxine is secreted from the thyroid gland to help
regulate metabolic function throughout the body. As we
age, the requirement for exogenous thyroid hormone in
hypothyroid patients decreases. It has been suggested
that elderly patients have a reduced need for levo-
thyroxine because of a decreased catabolism of the
hormone, but it is also possible that there is a reduction
in thyroid requirement. Ann Intern Med, Vol. 96, #1, p.
3751982:

BENOXAPROFEN:

Another non-steroidal, anti-inflammatory drug
(NSAID) is soon to be released for general medical use
in this country. Benoxaprofen (Oraflex) has a longer
duration of action than drugs currently in use. It needs
to be administered only once daily. The drug is to be
approved for rheumatoid and osteoarthritis. FDC Rep,
Vol. 44, #4, p. 3, 1982.

29

‘B Aowme magaynes, feprbaek books
mae, ad tome broek We dee eth

agatn one eee - inp yy

That's the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you’re not now offering periodicals to your customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

30 THE MARYLAND PHARMACIST

Classified Ads

Classified ads are a complimentary
service for members.

WANTED

Individuals interested in serving on the Association's Rehabilita-
tion Committee. Contact the Association office for details.

Pharmacist: Part time relief work in Hancock area, excellent
salary, flexible hours, pleasant working conditions, no front end
responsibilities. For more information call Jim Kirkwood. collect
717-761-0910

RECENTLY RETIRED PHARMACEUTICAL SALESPEOPLE wanted
for consultant part-time positions. For further details please
call Al McConnell, any Friday, collect, at (703) 435-0643.

PHARMACY FOR SALE

Ideal location on corner lot downtown Bel Air, one block from
new Court House and one block from new State office building.
Modern brick building, 8474 Sq. ft. floor space on two floors.
Owner will sell real estate, business, inventory and equipment.
Priced to sell. Worth looking into. Contact Charles V. Spalding,
Realtor, at 879-2500.

HOTLINE NUMBERS FOR
IMPAIRED PROFESSIONALS
467-4224
796-844 |
685-7878
467-3387

Physicians —
Dentists

Attorneys

Nurses

TEL-MED PROGRAMS IN OPERATION
THROUGHOUT MARYLAND
Prince George’s County
Cheverly
Sacred Heart Hospital
Cumberland
Provident Hospital
Baltimore
University of Maryland Hospital
Baltimore
Memorial Hospital
Easton

345-4080

777-8383

728-2900

528-3111

822-9198

SEPTEMBER, 1982

calendar &

Oct. 3—CECC Program on Cardiovascular Dis-

ease. Baltimore Hyatt.

Oct. 10O—14—NARD Convention, Boston

Oct. 17—MPhA Dinner Theatre, Burne Brae, Music
Man

Oct. 17—Fall Regional Meeting and Pharmacy

School Open House
Nov. 4—7—SAPhA Regional Convention, Baltimore
Nov. 14—Alumni Association Dinner Meeting
Every Sunday Morning at 6:30 a.m. on WCAO-AM and 8:00 a.m. on
WXYZ-FM, listen to Philip Weiner broadcast the Pharmacy Public

Relations Program ‘‘Your Best Neighbor,” the oldest continuous
public service show in Baltimore.

CENTENNIAL MARKET

* Each 1982 member of the Association is receiving a
special Centennial membership certificate. These cer-
tificates are sent at no additional charge as 1982 dues
are paid. Contact the office if you have a question about
this certificate.

* Special offer. A Mounting and display kit available
from the Association for displaying your Centennial
Certificate. $15.00 each from the Association office.

* The M.Ph.A. is offering to the public and its members
the USP publication, ‘‘About your Medicine.”’ This 400
page reference book covers the top 200 commonly used
medicines. $4.50 each plus $1.00 for postage etc. from
the Association office. Also available—‘About your
High Blood Pressure Medicine’’—$3.00 each plus $1.00
postage and handling.

*The Pharmacy Art Print ““Secundem Artem” is avail-
able from the Association office. This 18” « 24” full color
print is only $25.00 plus $3.00 for shipping and han-
dling.

* Centennial Apothecary Jars with the Association's
historic banner displayed is available for only $12.00
each which includes handling. Quantity discounts are
available and it makes an excellent gift.

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

31

Maryland Pharmaceutical
Association

Sponsors I.C. System Debt Collection Service

A PROFESSIONAL SYSTEM
Strong-arm tactics can backfire
in this age of consumerism.
This psychological approach
maintains goodwill while
inducing the debtor to pay you.

A REPUTABLE SYSTEM

|. C. System fully complies
with the Federal Fair Debt
Collection Practices Act, and
with state consumer protection
laws in force throughout the
country. As the law varies, so
do the methods.

A SAFE SYSTEM

A Hold Harmless indemnity
agreement protects you from
any legal entanglement
resulting from the company's
efforts to collect.

A NATIONAL
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There are divisions for 48
states. If the debtor moves, he
hears from his state division —
at no extra charge to you.
There is no need to rely on
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ITS EASY

Just turn in the debtor's name,
address, phone number, type
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PERSISTENCY PAYS

The company works every
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A COMPREHENSIVE
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All accounts — large or small,
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G Mail this form to:

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650 W. Lombard St
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State Zip

Title

Drug Taking and Elderly — Peter P. Lamy
Some Facts and Myths About Vitamins

Reducing Shoplifting Losses

1982-83 CONTINUING EDUCATION OPPORTUNITIES |

October 3, 1982: “Cardiovascular Drugs’”—CECC

October 12-14, 1982: ‘Concepts in Bioavailability’ — School
of Pharmacy

November 7, 1982: “OTC Counseling’ — MPhA

November 14, 1982: “Diabetes” — CECC

November 30, 1982: “Vitamin Marketing” — MPhA

March 13, 1983: “Communications and the Elderly” —
Center for Aging, MPhA

March 27, 1983: “Arthritis” — CECC

Watch for Details on these programs!

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746

OCTOBER 1982 VOL. 58 NO. 10

CONTENTS

President’s Message

Drug Taking and the Elderly—Peter P. Lamy

Some Facts and Myths About Vitamins
Reducing Shoplifting Losses

Abstracts

DEPARTMENTS

19 Calendar
31 Classified Ads

23 Letters to the Editor

ADVERTISERS

Boots Mayer and Steinberg
District Paramount Photo A. H. Robins

The Drug House Roche

Eli Lilly and Co. Selby Drug Co.
Loewy Drug Co. Upjohn

Maryland News Distributing

Change of address may be made by sending old address (as it appears on your journal) and
new address with zip code number. Allow four weeks for changeover. APhA member —
please include APhA number.

The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar-
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as
part of their annual membership dues. Entered as second class matter at Baltimore, Mary-
land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201.

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor
ABRIAN BLOOM, Photographer

Officers and Board of Trustees
1982-83

Honorary President

WILLIAM J. KINNARD JR., Ph.D. — Baltimore
President

MILSON SAPPE, P.D. — Baltimore
Vice-President

WILLIAM C. HILL, P.D. — Easton
Treasurer

MELVIN RUBIN, P.D. — Baltimore
Executive Director

DAVID A. BANTA, C.A.E. — Baltimore
Executive Director Emeritus

NATHAN GRUZ, P.D. — Baltimore

TRUSTEES

PHILIP H. COGAN; P:D: — Chairman
Laurel

RONALD SANFORD, P.D. (1985)
Catonsville

JAMES TERBORG, P.D. (1985)
Aberdeen

GEORGE C. VOXAKIS, P.D. (1984)
Baltimore

BARBARA BARRON, P.D. (1983)
Rising Sun, Maryland

CHERYL BETZ, SAPhA (1983)
Baltimore

EX-OFFICIO MEMBER
WILLIAM J. KINNARD, JR., Ph.D. — Baltimore

HOUSE OF DELEGATES

Speaker

STANTON BROWN, P.D. — Silver Spring
Vice Speaker

HARRY HAMET, P.D. — Baltimore

MARYLAND BOARD OF PHARMACY
Honorary President

I. EARL KERPELMAN, P.D. — Salisbury
President

BERNARD B. LACHMAN, P.D. — Pikesville
ESTELLE G. COHEN, M.A. — Baltimore
LEONARD J. DeMINO, P.D. — Wheaton
RALPH T. QUARLES, SR., P.D. — Baltimore
ROBERT E. SNYDER, P.D. — Baltimore
ANTHONY G. PADUSSIS, P.D. — Timonium
PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, B.A. — Baltimore

THE MARYLAND PHARMACIST

President's Message

As President, I am given this space to comment on any of the many
facets that touch pharmacy or our Association. I would like to give some
well-deserved praise to a committee that probably should have more, the CECC
(Continuing Education Coordinating Council). For those who do not know of it
or do not know very much about it, the Council is a tripartite effort of the
MPhA, the Maryland Society of Hospital Pharmacists and the School of Phar-
macy. I am very proud to have served on this Committee for a space of time and
know first hand the planning and hard work that goes into its programs. It 1s a
group composed of members of each parent organization that meet on a con-
tinual basis, and more than most committees, putting together small and large
continuing education programs for all of us. They have generally prepared four
large programs, two or three small specialized programs and an on-going “*Road
Show’’ that moves around the State each year. Each program is visualized,
planned and presented. Very simple to say, but complicated and time consum-
ing to accomplish.

I am certain that all of us, whether we are community, hospital or con-
sultant pharmacists, say to ourselves that we do not have enough time, or the
Colts are playing, or some other rationalization so that we might make our-
selves believe we can not attend these programs. It behooves all of us to re-
member that we picked this profession of Pharmacy as our life’s work and, if we
do not grow and continue to learn, we will stagnate and be replaced. The value
is not just in what is derived from the programs themselves, but is also in the
give and take of discussion with your peers that open new insights into profes-
sional and business decisions. Professional and trade journal reading will not
suffice. Most of us are not disciplined enough to’set allotted time aside for
study.

Start now and initiate your own ‘‘IRA”’ (Individual Redevelopment Ac-
tion). Set aside a small portion of your time to attend these educational meet-
ings and give the Council the benefit of your thinking on future subjects. I am
certain the Council is always searching for methods to fill a need in the profes-
sion.

Thank you CECC.

Milton Sappe,

PRESIDENT

OCTOBER, 1982

Drug-Taking Behavior
and the Elderly

by Peter P. Lamy

snes

Peter P. Lamy, Ph.D., F.A.G.S., is professor and director, Center
for the Study of Pharmacy and Therapeutics for the Elderly, Chair-
man, Department of Pharmacy Practice and Administrative Science,
University of Maryland School of Pharmacy, Baltimore, Maryland
21201.

4

Drug therapy far too often ends in failure these days,
especially among the elderly. Patient-practitioner en-
counters become disappointing and fruitless attempts at
achieving therapeutic goals, leading to more frustration
and failures and, finally, total lack of medical help.

The primary cause of these failures is lack of com-
pliance. There is a complete failure to take medications
in up to 50% of all cases, with varying degrees of non-
compliance reported to range from 4—92%, depending
on a number of variables.

To complicate matters, compliance is not a consis-
tent behavior in a given individual; compliance with one
regimen does not mean that a patient will automatically
comply with another one.

Furthermore, scores of studies have proven that el-
derly patients make serious mistakes with their
medicines because of confusion or forgetfulness.

Earlier reports were that, despite the time spent by
the physician or pharmacist with elderly patients, their
record of compliance was generally poor. More re-
cently, however, encouraging reports are that elderly
comply with treatment regimens to the same degree that
younger patients do given the same amount of instruc-
tion. In fact, some studies show that some elderly pa-
tients demonstrate a surprising accuracy in self-
administration of drugs.

The primary problem, of course, is that when elderly
patients don’t comply or don’t use drug products cor-
rectly, the deleterious effects can be more severe than
in younger patients. Psychiatric complications are not
uncommon and can lead to the catch-all diagnosis of
senility, further complicating the issue. Furthermore,
many adverse effects result from an excessive dose or
duration of drug use, both of which would be questioned
by an informed patient.

Noncompliance can take many forms and has a
number of causes, among which are:

* Using a drug incorrectly. Unit-dose drugs are
sometimes taken unwrapped, the desiccant in prepack-
aged tablets is swallowed, not enough water is taken

THE MARYLAND PHARMACIST

with bulk laxatives or aspirin, antacids are not chewed,
or the drug is taken (not taken) with meals (milk, etc.).

* There are physical barriers to compliance. For
example, many elderly patients have difficulty opening
child-proof containers and do not realize that they may
request containers that are not child-proof.

* The senses are not as sharp. Vision, hearing,
touch, taste, odor, or color perception may be di-
minished and lead to a number of potential errors in
medication-taking.

* Use of many drug products. Elderly average 4—7
different drug products used for chronic conditions,
leading to greater chance of error. It is often suggested
that drug regimens including more than four drugs are
unsafe without close supervision.

* Written and/or verbal instructions are incom-
prehensible. Far too often the label is a collection of
medical shorthand that takes the place of poor hand-
writing. Patient information sheets are not yet widely
used. Auxiliary labels are used too seldom. And not
enough verbal reinforcement is offered in the majority
of cases. Studies indicate that instructions are fre-
quently misunderstood and too quickly forgotten. Fur-
thermore, great variations exist in the interpretation of
both verbal and written instructions.

Potentially more hazardous is the common practice
of writing *‘Take as directed,’ which places the total
burden of both decision-making and recall on the pa-
tient, who may not have received directions in the first
place. Even when this is coupled with verbal instruc-
tions, elderly patients often have more difficulty recall-
ing verbal instructions, particularly when they are tak-
ing a number of drug products.

Patient Participation

It is not an easy task to identify the potential non-
complying patient beforehand. Noncompliance usually
becomes apparent only after its effects become visible.

Clearly, one way of measuring noncompliance is
through patient records. It is a good idea to keep close
tabs on the records of all elderly patients to help them
monitor their drug therapy. Elderly patients too often
do not receive the attention they need. They have more
problems and often require more time to give and re-
ceive information. Moreover, elderly frequently live
alone or with another elderly person and do not receive
close monitoring of their drug utilization. And, research
shows, the duration of encounters between physicians
and patients also declines with age.

The fact that a patient does not question instructions
does not mean—and should not be understood to
mean—that the patient understands them. Furthermore,
the attitude that ‘“‘the doctor will tell me what I need to
know” still is encountered frequently among elderly
patients.

How can patient compliance among the elderly be
improved?

OCTOBER, 1982

Many different programs and methods have been
studied. Onset of illness type of illness, age, sex, edu-
cation, social class, occupation, income, marital status,
race and ethnicity, religion, and certain personality
measures will have been investigated and found to lack
correlation with compliance and behavior.

Moreover, there is no agreement as to the effect of
patient surveillance. The social science literature seems
to indicate that strong surveillance reduces compliance
while the medical literature seems to support the oppo-
site viewpoint.

Special packaging, special prescriptive containers,
and the use of pill calendars all have been suggested, but
compliance is not significantly improved with different
packaging or memory aids alone which, at best, can
only support compliant behavior.

The real answer would appear to be the develop-
ment of self-management programs that actively involve
the patient, coupled with strong patient education and
continued reinforcement of verbal and written instruc-
tions by all health professionals.

Self-Management

Under section 504 of the federal Rehabilitation Act
of 1973, a patient has the right to appropriate treatment
and a right to refuse treatment. The rights were rein-
forced in 1978 by the President’s Commission on Mental
Health which established that freedom of choice is
among the most basic principles of society.

Implicit within that context, however, is the concept
that patients have enough information upon which to
base a rational decision, a choice that can be made by an
informed and aggressive patient. Yet, the aged often are
not well enough informed nor aggressive enough to
make such decisions. Fear and anxiety leads them to
accept, even prefer to be told, the type of treatment (or
no treatment) they should expect. They don’t consider
themselves as a necessary part of the treatment plan.

Both provider and patient have an important role in
the ultimate outcome of appropriate drug use. The man-
agement of chronic diseases, prevalent among the el-
derly, demands a serious commitment by the patient to
compliance with recommended regimens and coopera-
tive interactions with the provider.

The importance of good provider-patient relations
cannot be stressed too much. The patient must assume
the role of aide-therapist, exchanging information with
the provider, leading to more effective therapeutic
regimens. The elderly must be taught and encouraged to
become active partners in therapy and compliance, pro-
viding the physician and the pharmacist with informa-
tion and, in turn, eliciting the information they need to
ensure their drug therapy.

Pharmacists have a large role to play both with their
individual patient and with the growing elderly commu-
nity in general to convince them of their part in staying
healthy and complying with drug regimens.

Pp)

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own right as you are in yours.

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of our products on a professional level.

FIELD CERTIFICATION...

by a Roche division manager is required of our
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and is a prerequisite for each new Roche represen-
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is never time-consuming and always informative.

ANNUAL REVALIDATION...

of each representative’s product and technical
knowledge is Roche policy. And it’s a good policy,
as it ensures that our people keep abreast of devel-
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Roche Professional Services.

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Some Facts And Myths
Of Vitamins

Vitamins are essential to human life, but
their true role in the body and in nu-
trition is often misunderstood. This
primer on vitamins explains what vi-
tamins are and how they work.

itamins are organic compounds
VV concen in small amounts in the
diet for the normal growth and main-
tenance of life of animals, including
man.

They do not provide energy, nor do
they construct or build any part of the
body. They are needed for transform-
ing foods into energy and body main-
tenance. There are 13 or more of them,
and if any is missing a deficiency dis-
ease becomes apparent.

Vitamins are similar because they
are made of the same elements—car-
bon, hydrogen, oxygen, and some-
times nitrogen. (Vitamin B,, also
contains cobalt.) They are different in
that their elements are arranged dif-
ferently, and each vitamin performs
one or more specific functions in the
body.

In the early 1900's scientists thought

&

that three compounds were needed in
the diet to prevent beriberi, pellagra,
and scurvy. Those compounds origi-
nally were believed to belong to a class
of chemical compounds called amines
and were named from the Latin vita,
or life, plus amine—vitamine. Later,
the ‘‘e”’ was dropped when it was found
that not all of the substances were
amines.

At first, no one knew what they were
chemically, and they were identified by
letters. Later, what was thought to be
one vitamin turned out to be many,
and numbers were added; the Vitamin
B complex is the best example.

Then some were found unnecessary
for human needs and were removed
from the list, which accounts for some
of the gaps in the numbers. For ex-
ample, B,, adenylic acid; B,,, orotic
acid; and B,,, pangamic acid. Others,
originally designated differently, were
found to be the same. For example,
vitamins H, M, S, W, and X were all
shown to be biotin; vitamin G became
vitamin B, (riboflavin); and vitamin Y
became vitamin B, (pyridoxine, pyri-

doxal, and pyridoxamine). Vitamin M
seems to have been used for three dif-
ferent vitamins—folic acid, panto-
thenic acid, and biotin. The present
trend is to eliminate the confusion by
using the chemical names.

Extremely sensitive methods of
measuring the potency or quantity of
vitamins have been developed because
they are present in foods only in very
small amounts. Some vitamins are
measured in I.U.’s (international units),
which is a measure of biological activ-
ity. This is necessary because these
vitamins have several natural forms
that have different activities on an
equal weight basis. The others are ex-
pressed by weight in micrograms or
milligrams.

To illustrate the small amounts
needed by the human body, let’s start
with an ounce, which is 28.3 grams. A
milligram is 1/1000 of a gram, and a
microgram is 1/1000 of a milligram.
The U.S. Recommended Daily Allow-
ance (U.S. RDA) of vitamin B,, for an
adult is 6 micrograms a day. Just one
ounce of this vitamin could supply the

THE MARYLAND PHARMACIST

daily needs of 4,724,921 people!

Getting enough vitamins is essential
to life, although the body has no nu-
tritional use for excess vitamins and
some vitamins can be stored only for
relatively short periods. Many people,
nevertheless, believe in being on the
“safe side” and thus take extra vita-
mins. However, a well-balanced diet
will usually meet all the body’s vitamin
needs.

So-called average or normal eaters
probably never need supplemental vi-
tamins, although many think they do.
Vitamin deficiency diseases are rarely
seen in the U.S. population. People
known to have deficient diets require
supplemental vitamins, as do those re-
covering from certain illnesses or vi-
tamin deficiencies.

People who are interested in nutri-
tion and good health should become
familiar with the initials U.S. RDA.
“United States Recommended Daily
Allowances” were adopted by FDA
for use in nutrition labeling and special
dietary foods. They are the highest
amounts of vitamins, minerals, and
proteins that are needed by most peo-
ple each day.

The accompanying table lists the
U.S. RDA’s for vitamins used in nu-
trition labeling of foods, including
foods that are also vitamin supple-
ments. The table is not complete be-
cause it lists only vitamins. The
complete table of U.S. RDA’s also in-
cludes specific minerals and protein.

Vitamin A—Retinol

Vitamin A is an oil soluble vitamin
like D, E, and K, and 1s stored in
the liver. (Generally, oil soluble vita-
mins can be stored for long periods—
even indefinitely—in the body.
Water soluble vitamins are retained
for short periods, if at all.) This vita-
min is necessary for new cell growth
and healthy tissues and is essential
for vision in dim light. Besides re-
sulting in reduced ability to see in
dim light (night blindness), high sen-
sitivity to light, and other eye mala-
dies, vitamin A deficiency can cause
dry, rough skin that may become
more susceptible to infection.

Children and young people who
have been given large doses of vita-
min A have developed an increased
pressure inside the skull that mimics

OCTOBER, 1982

symptoms of a brain tumor so con-
vincingly that in several cases hospi-
tal personnel made preparations for
surgery before the high intake of vi-
tamin A was discovered. Carotene, a
form of Vitamin A that occurs in
plants is, on the other hand, practi-
cally nontoxic.

Vitamin A activity is found in
foods in two forms: carotene, a yel-
low pigment in green and yellow veg-
etables and yellow fruits that the
human body converts to vitamin A,
and vitamin A itself, formed from
carotene by other animals and stored
in certain food tissues such as liver,
eggs, and milk.

Vitamin B,—Thiamin

This vitamin is water soluble, as
are all in the B complex. Thiamin is
required for normal digestion,
growth, fertility, lactation, the nor-
mal functioning of nerve tissue, and
carbohydrate metabolism.

Vitamin B, deficiency causes beri-
beri, a dysfunctioning of the nervous
system. Other deficiency problems
are loss of appetite, body swelling
(edema), heart problems, nausea,
vomiting, and spastic muscle contrac-
tions throughout the body.

Thiamin is abundant in pork, soy-
beans, beans, peas, nuts, and in en-
riched and whole-grain breads and
cereals.

Vitamin B,—Riboflavin

Riboflavin helps the body obtain
energy from carbohydrates and pro-
tein substances. A deficiency causes
lip sores and cracks, as well as dim-
ness of vision. This vitamin is abun-
dant in leafy vegetables, enriched
and whole-grain breads, liver,
cheese, lean meats, milk, and eggs.

Niacin

Niacin is necessary for the healthy
condition of all tissue cells. A defi-
ciency causes pellagra, which was
once, next to rickets, the most com-
mon deficiency disease in the United
States. Pellagra is characterized by
rough skin, mouth sores, diarrhea,
and mental disorders.

Niacin is one of the most stable of
the vitamins, the most easily ob-

tained, and the cheapest. The most
abundant natural sources are liver,
lean meats, peas, beans, enriched
and whole-grain cereal products, and
fish.

Pantothenic Acid

Pantothenic acid is needed to sup-
port a variety of body functions, in-
cluding proper growth and
maintenance. A deficiency principally
causes headache, fatigue, poor mus-
cle coordination, nausea, and
cramps.

Pantothenic acid is abundant in
liver, eggs, white potatoes, sweet po-
tatoes, peas, whole grains (particu-
larly wheat), and peanuts.

Folic Acid (Folacin)

Folic acid helps the body to manu-
facture red blood cells and is essen-
tial in normal metabolism which is,
basically, the conversion of food to
energy. A deficiency causes a type of
anemia.

The most abundant sources are
liver, navy beans, and dark green
leafy vegetables. Other good sources
are: nuts, fresh oranges, and whole
wheat products.

Vitamin B,—Pyridoxine—Pyridoxal—
Pyridoxamine

Vitamin B, has three forms but all
are used by the body in the same
way. ;

This vitamin ts involved mostly in
the utilization of protein. As with
other vitamins, B, is essential for the
proper growth and maintenance of
body functions. Deficiency symptoms
include mouth soreness, dizziness,
nausea, and weight loss, and some-
times severe nervous disturbances.

Pyridoxine is found abundantly in
liver, whole-grain cereals, potatoes,
red meats, green vegetables, and yel-
low corn.

Vitamin B,,—Cyanocobalamin

Vitamin B,, is necessary for the
normal development of red blood
cells, and the functioning of all cells,
particularly in the bone marrow,
nervous system, and intestines.

A deficiency causes pernicious ane-

9

mia, and if the deficiency is pro-
longed, a degeneration of the spinal
cord occurs.

Abundant sources are: organ
meats, lean meats, fish, milk, eggs,
and shellfish. B,, is not present to
any measurable degree in plants,
which means that strict vegetarians
should supplement their diets with
this vitamin.

Biotin

Once called vitamin H, biotin is
now the sole descriptive term for this
vitamin, which is actually a member
of the B complex. It is important in
the metabolism of carbohydrates,
proteins, and fats.

Most deficiency symptoms involve
mild skin disorders, some anemia,
depression, sleeplessness, and muscle
pain. A deficiency is extremely rare
and this is probably because the bac-
teria in the intestinal tract produces
biotin so that more is excreted than
was consumed in the diet.

Abundant dietary sources include
eggs, milk, and meats. Raw egg
white contains a factor that destroys
biotin.

Vitamin C—Ascorbic Acid

This least stable of the vitamins

promotes growth and tissue repair,
including the healing of wounds. It
aids in tooth formation and bone for-
mation. When used as a food addi-
tive, vitamin C acts as a preservative.

Lack of this vitamin causes scurvy,
one of the oldest diseases known to
man. The signs of scurvy include: las-
situde, weakness, bleeding, loss of
weight, and irritability. An early sign
is bleeding of the gums and ease of
bruising. Long before the 16th cen-
tury, American Indians knew that
scurvy could be cured by a tea made
with spruce or pine needles.

Abundant sources are turnip
greens, green pepper, kale, broccoli,
mustard greens, citrus fruits, straw-
berries, Currants, tomatoes, and
other vegetables. You can get all the
vitamin C your body needs by eating
a daily 3- to 4-ounce serving of any
of the foods named.

Vitamin D—Calciferol

This vitamin also exists in several
forms. The most common (and
equally effective) are ergocalciferol—
vitamin D,, and cholicalciferol—vita-
min D,. The D, is a plant source; the
D, comes from animal sources.

Vitamin D aids in the absorption
of calcium and phosphorus in bone
formation. To accomplish its work,

the body—through the liver and the
kidneys—converts the vitamin to a
hormone-like material.

Vitamin D deficiency causes rick-
ets. The obvious signs are skeleton
deformation—bowed legs, deformed
spine, “‘potbelly” appearance, and
sometimes flat feet and stunting of
growth.

Too much vitamin D can cause
nausea, weight loss, weakness, exces-
sive urination, and the more serious
conditions of hypertension and calci-
fication of soft tissues, including the
blood vessels and kidneys. Bone de-
formities and multiple fractures are
also common. In fact, many of the
symptoms from an excess of vitamin
D are remarkably similar to those
caused by a deficiency.

Abundant sources are canned and
fresh fish (particularly the salt water
varieties), egg yolk, and the vitamin
D-fortified foods such as milk and
margarine. People who spend part of
their time in the sun with exposure
of the skin need no other source of
vitamin D, since it is formed in the
skin by the ultraviolet rays. Foods
fortified with vitamin D are intended
mainly for infants and the elderly
who lack exposure to sunlight. The
daily requirement is very small and
excess amounts above that are stored
in the body.

United States Recommended Daily Allowances

Unit
Vitamin A IU
Vitamin D Lia
Vitamin E IU
Vitamin C mg
Folacin mg
Thiamine (B,) mg
Riboflavin (B,) mg
Niacin mg
Vitamin B, mg
Vitamin B,, mcg
Biotin mg
Pantothenic acid mg

IU = International unit
mg = milligram
mcg = microgram

Infants Children
(0-12 mo.) under 4 yrs.
1500 2500
400 400
S 10
35 40)
Os] 0.2
0.5 a7
0.6 0.8
8 9
0.4 0.7
2 5
0.05 eS
3 5

Adults Pregnant or
and children lactating
4 or more yrs. women
S000 8000
400 400
30 30
60 60
0.4 0.8
1) esi
led! 2.0
20 20
2 Pie
6 8
0.3 0.3
10 10

The U.S. RDA system was developed by FDA for its nutrition labeling and dietary supplement programs. This
table for use in the labeling of dietary supplements lists only vitamin requirements, for the purpose of this article.

10

THE MARYLAND PHARMACIST

Vitamin K

There are several natural forms of
vitamin K, which are essential to
cause clotting of the blood. One
type, K,, occurs in plants. Another,
K,, is formed by bacteria in the in-
testinal tract. Yet a third is found in
some animals and birds. The syn-
thetic vitamin K, menadione, be-
cause of the potential for harm
involved in its use, is dispensed only
by prescription. Phyloquinone, K,,
may be used in dietary supplements
up to a level of 100 micrograms per
recommended daily quantity.

A deficiency causes hemorrhage
and liver injury. Vitamin K is found
in spinach, lettuce, kale, cabbage,
cauliflower, liver, and egg yolk.

Vitamin E—The Tocopherols

Vitamin E in humans acts as an
antioxidant that helps to prevent oxy-
gen from destroying other sub-
stances. In other words, vitamin E is
a preservative, protecting the activity
of other compounds such as vitamin
A. No clinical effects have been asso-
ciated with very low intake of this vi-
tamin in man. A rather rare form of
anemia is premature infants, how-
ever, responds to vitamin E medica-
tion. A diet high in polyunsaturated
fat requires a small increase in die-
tary vitamin E to prevent oxidation
of this rather unstable form of fat.

Abundant sources are vegetable
oils, beans, eggs, whole grains (the
germ), liver, fruits, and vegetables.

Vitamin E is one of the most
talked about vitamins, and to some
extent the exaggerated and unsub-
stantiated claims made for vitamin E
result from a combination of hope
and misinterpretation.

The Committee on Nutritional
Misinformation of the National
Academy of Sciences has issued a re-
port on vitamin E. Three statements
are quoted here:

“Surveys of the U.S. population indi-
cate that adequate amounts of vitamin
E are supplied by the usual diet.”’

“Careful studies over a period of
years attempting to relate these (test
animal) symptoms to vitamin E defi-
ciency in human beings have been un-
productive.”

“Self-medication with vitamin E in
the hope that a more or less serious
condition will be alleviated may in-
deed be hazardous, especially when
appropriate diagnosis and treatment
may thereby be delayed or avoided.”

Most of us view scientific knowl-
edge with awe, and we are quite jus-
tified, considering the scientific
achievements of our age. Misconcep-
tions about vitamins and their proper
functions are understandable; no
primer would be complete that fails
to clear up some of these misconcep-
tions:

Myth: Organic or natural vitamins
are nutritionally superior to
synthetic vitamins.

Fact: Synthetic vitamins, manufac-
tured in the laboratory, are
identical to the natural vita-
mins found in foods. The
body cannot tell the difference
and gets the same benefits
from either source. State-
ments to the effect that “‘Na-
ture cannot be imitated’’ and
“Natural vitamins have the
essence of life’ are without
meaning.

Vitamins give you ‘‘pep’’ and
““energy.”’

Myth:

Vitamins yield no calories.
They, of themselves, provide
no extra pep or vitality be-
yond normal expectations,
nor an unusual level of well-
being.

Fact:

Myth: The more vitamins the better.

Fact: Taking excess vitamins is a
complete waste, both in
money and effect. In fact, as
noted, excess amounts of
some vitamins can be harm-

ful.

You cannot get enough vita-
mins from the conventional
foods you eat.

Myth:

Fact: Anyone who eats a reasona-
bly varied diet of whole food,
should normally never need

supplemental vitamins.

The abundant sources listed give
some idea of how difficult it is to be
undernourished from lack of vitamins.

Each of the following is not only an
abundant source of one or more vita-
mins, but also contains important
amounts of most of the rest of the nu-
trients:

Liver; eggs, cheese; fortified mar-
garine; butter; whole milk; fortified
milk; fish; egg yolk; yellow vegetables;
green leafy vegetables; yellow fruits;
beans; peas; nuts; whole-grain foods;
red meats; lean meats; pork; shellfish;
fresh vegetables; white potatoes; sweet
potatoes; yellow corn; rice; strawber-
ries; currants; citrus fruits and juices;
tomatoes and juices; other fruits, juices,
and berries; canned and fresh herring;
salmon; tuna; lettuce; fresh oranges;
cabbage; spinach; cauliflower; and
vegetable oils of several kinds.

Even though the widely seen and
identified vitamin deficiency diseases
of 30 years ago have all but disap-
peared, the American consumer is ap-
proached from all sides with
misinformation about the almost uni-
versal “need” for supplements of vi-
tamins.

Is there really a need? Each person
can answer this only after examining
his or her regular diet and learning
what vitamins can and cannot do.

(CONSUMER

OCTOBER, 1982

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Reducing Shoplifting Losses

by Addison H. Verrill

Summary

Shoplifters and magicians have one thing in common. Both rely on sleight-of-
hand. However, amusement turns to anguish when individuals who pretend to be
customers come into a small store and prove that “‘the hand is quicker than the
eye.’ The methods which shoplifters use are discussed in this paper, and the
types of persons who practice this form of thievery are described. Theypaper also
gives practical suggestions on using protective devices, on what employees must
do, and on apprehending and arresting shoplifters.

The author is president of Dale System Incorporated, New York, N.Y.

Shoplifters are stealing me blind, is a complaint
made by many retailers. And rightly so, because in
some localities the shortages caused by nimble-fingered
artists are the greatest percentage of a retailer’s inven-
tory shrinkage.

Unfortunately, there is no easy way to break up
such thievery. It is a constant battle in which you must
fight individual engagements. One difficulty is identify-
ing your opponent. Challenging an innocent person can
be costly as well as embarrassing.

A key to reducing shoplifting losses is knowning
your man and catching him in the act. What methods are
used by the shoplifter? What kind of person is he?

14

Methods of Shoplifters

Professional shoplifters are sleight-of-hand experts.
Under ordinary circumstances, they can, and do, snatch
items from counters and pass these items to confeder-
ates without detection.

The best protection a retailer has is a sales force
trained to watch for such things. In stores where clerks
are not wide awake, shoplifters can literally take over.
These thieves have been known to step behind coun-
ters, pose as sales clerks, and collect money from cus-
tomers.

As for the hand-is-quicker-than-the-eye techniques,
shoplifters come equipped with coats and capes which

THE MARYLAND PHARMACIST

have hidden pockets and slits or zippered hiding places.
Hands emerge unseen from slits to snatch up articles
directly from open displays. Many times, such perfor-
mances are blocked from view by the open coat itself.
These shoplifters are also adept at palming small items
with the cover-up aid of loose handkerchiefs and gloves.

Sometimes shoplifters have special hooks or belts
on the insides of their coats or tricky aprons and under-
garments designed to hold innumerable articles. Some
sleight-of-hand thieves slip merchandise into packages
or into boxes that have a hinged top, bottom, or end.
Salesclerks should know how to spot such devices.
Employees should also be suspicious of and watch
shoppers who carry bulky packages, knitting bags,
shopping bags, and umbrellas. These are handy recep-
tacles for items which a shoplifter purposely knocks off
counters.

Some shoplifters do not confine their activity to
shopowners. They even steal from customers. They
pick up packages or handbags which store patrons
carelessly lay aside in their preoccupation with shop-
ping.

Ticket switching is another method used by shop-
lifters. It is an especially vexing problem for owner-
managers of a store. It is almost impossible to prove the
guilt of a ticket switcher, for one thing. Also there is the
hazard of false arrest countercharges.

Types of Shoplifters

Fortunately for the owner-manager of a small store,
the majority of shoplifters are amateurs rather than
professionals. A breakdown of various types should
help you to understand the motives which cause these
individuals to steal and the methods they use.

JUVENILE OFFENDERS. The young make up
about 50 percent of all shoplifters, and indications are
that this type of offender is on the increase. Sometimes
youngsters steal ‘for kicks’’ or because they have been
‘‘dared’’ to do so. They may enter stores in gangs. In
order to discourage these rebellious and unsupervised
juveniles, retailers should ‘‘get tough.’’ Youth is no ex-
cuse for crime. It should be prosecuted and made to pay
through the proper legal channels.

OCTOBER, 1982

HOUSEWIVES. Many retailers report that the
majority of adults who are apprehended are women, and
a significant number of them are housewives. They steal
because they have given in to momentary impulse and
temptation. Many of them are first offenders and by
catching them, you may help prevent them from be-
coming habitual shoplifters.

KLEPTOMANIACS. Thefts by kleptomaniacs
stem from psychological compulsions. The term is a
combination of the Greek word for thief, “‘kleptes,’’ and
the word ‘‘maniac.’’ Often kleptomaniacs do not need
the items they pick up. But even so their behavior is no
less costly to you.

DRUNKARDS AND VAGRANTS. Drunkards
and vagrants are probably the most clumsy shoplifters
and the easiest to detect. They often steal because they
desperately need money and food.

NARCOTICS ADDICTS. Drug addicts are, of
course, more desperate than vagrants. Also addicts may
be armed. They should be handled by the police.

PROFESSIONAL SHOPLIFTERS. The profes-
sional is the most difficult type to detect and apprehend.
He is clever at his craft. When he comes into the store,
he often pretends that he is shopping for something to
buy for his wife.

The professional shoplifter is ‘‘in business’’ for
money. He usually steals to resell his loot to established
fences. He often has a police record. Indeed, he may
belong to an underworld organization which will supply
bail and help him in court.

The professional can be discouraged from stealing if
he sees that store personnel are really alert.

Call the Police

Regardless of the type of shoplifter, the common
answer that most shoplifters give when caught is: “‘I
have never done this before.”

Failure to prosecute ‘‘first offenders’? encourages
shoplifting. It is best to operate on the premise that he
who steals will also lie. Call the police when you catch a
shoplifter.

When every merchant in town follows the policy of
prosecuting each shoplifter, the word gets around. Hard-

Is

ened professionals will avoid the town. Amateurs will
think twice before yielding to the temptation to pocket a
choice item.

Protective Personnel and Devices

In reducing shoplifting losses, the deterrent factor is
all important. Protective devices help you to discourage
borderline shoplifters—ones who don’t steal unless the
coast is clear—and to trap bold ones. Among these de-
vices are two-way mirrors, peepholes, closed-circuit
television, radio communication, and detectives posing
as customers.

Some large stores use uniformed guards and
plainclothes personnel who serve as a reminder to pa-
trons that only legally purchased merchandise may be
removed from the premises. One way to identify such
merchandise is to use stapled packages with receipts
attached outside.

When you have no guards and rely solely on your
own people, convex wall mirrors can be helpful. They
allow store personnel to see around corners and keep
several aisles under observation from regular work sta-
tions.

Anti-shoplifting signs prominently displayed warn
potential thieves and deter some. Various uses of public
address systems have also been employed to discourage
shoplifters. When a suspect has been observed, a
‘‘walkie-talkie’’ radio can be used for speedy communi-
cation between you and those employees who handle
such situations.

Electronic devices which expose the shoplifter are
also on the market. One example of such a device is an
electronic pellet or wafer attached usually to an expen-
sive garment so that it cannot be removed without tear-
ing the merchandise. If a shopper tries to remove the
garment from the store, the pellet or wafer sends out
signals. The cashier removes the pellet with special
shears when the customer purchases the garment.

You should keep in mind that there is a legal danger
in using electronic devices. If the cashier forgets to re-
move the pellet device, an innocent shopper may be
stopped outside and falsely detained.

When shoplifters use ticket switching to gain their
ends, you can use the following alternatives:

16

(1) Tamper-proof gummed labels which rip apart
when attempt is made to remove labels.

(2) Hard-to-break plastic string for softgoods tickets.

(3) When tickets are stapled on, special staple pat-
terns are used which are recognizable to store personnel.

(4) Extra price tickets are concealed elsewhere on
merchandise.

If you use simple and basic pricing methods, don’t
ticket prices in pencil. Use a rubber stamp or pricing
machine.

Physical Layout of Stores

A store’s layout can discourage or encourage shop-
lifting. For example, high fixtures and tall displays
which give visual protection to the shoplifter will en-
courage his practices. To destroy such protection, set
your display cases in broken sequences. If possible, run
them for short lengths with spaces in between.

Keep small, high-priced items out of reach, prefera-
bly in locked cases. Keep valuable and easy-to-hide
items at counters where clerks are in continuous atten-
dance. Or better yet, let the customer ask a salesman to
show him such items.

If fire safety regulations allow it, lock all exits not to
be used by customers. In addition, attach noise alarms
to the exits which must be kept unlocked. Always close
and block off unused checkout aisles.

What Employees Must Do

Employees must watch merchandise and people if
you are to prevent shoplifting. Generally, your
salesclerks should be alert to persons who wear loose
coats or capes or bulky dresses. They should also watch
persons who carry large purses, packages, umbrellas,
and shopping bags. Those who push baby strollers and
collapsible carts also bear watching as well as individu-
als who walk with short steps. The latter may be carry-
ing stolen goods between their legs.

In clothing stores, clerks should beware of the
‘“‘try-on’’ shoplifters. They try on an item for size, as it
were, and then, if they feel no one has seen them, walk
out wearing the garment. Salespeople should keep a
check on the number of garments carried into the fitting

THE MARYLAND PHARMACIST

rooms. Thieves often try to sneak in extra garments
beyond the number permitted.

You and your people should be especially alerted for
‘‘teams’’—thieves who pretend not to know each other.
One of the team will attract the clerk’s attention away
from the partner. He will cause a fuss, ask unreasonable
questions, create an argument, even stage fainting fits
while his partner picks up the merchandise and makes a
quick exit.

Sales persons should keep in mind that ordinary
customers want attention while shoplifters do not.
When busy with one customer, the salesman should ac-
knowledge other customers with polite remarks such as,
“Tl be with you in a minute.’’ It can make a shoplifter
feel uneasy. Such attention pleases ordinary customers.

Salesclerks should not give the impression that they
distrust customers, but they must always be alert to
their movements. If possible, they never should turn
their backs to customers even when fetching merchan-
dise for them. They should display merchandise neatly
because missing items are easily detected when orderly
arranged.

You should schedule your employees’ working
hours with floor coverage in mind. An adequate number
of clerks should be on duty during your store’s busy
periods. These periods are most conducive to theft.

Finally, and most important, you should instruct
employees about what they are to do when they observe
a theft by a shoplifter. This training should be done
periodically, at least once every 3 months. Such knowl-
edge helps prevent legal problems in addition to catch-
ing offenders.

Apprehension and Arrests

Be certain or risk a false arrest suit is a good rule to
follow when catching a shoplifter.

In pursuing this rule, salespersons should not accuse
patrons of stealing. Nor should they try in any way to
apprehend shoplifters. When a salesperson sees what
appears to be a theft, he should keep the suspect in sight
and alert you immediately. The police or the store de-
tective should be notified if you use one. In fact, sales-
persons should alert you about any suspicious loiterers.

If your refund desk clerk receives a returned item

OCTOBER, 1982

and recognizes it as a stolen or suspicious item, she
should delay the person and call you. Ask the person for
identification and have him sign his name and address.
If the item is stolen, he will usually give a wrong name
and have no identification.

Some organizations in large cities have control files
on shoplifters who have been caught. Your retail mer-
chant’s association can inform you about the services
available in your area. You can check these files to see
whether the person you catch has a record. Usually a
shoplifter claims to be a first offender. He is apt to
remain a ‘‘first offender’? if the merchant allows him to
leave without positive identification and without filing
his name with the police and local retail merchant as-
sociation.

You should also check to see what the law is in your
State. Many States have passed “‘shoplifting laws’’
which, among other things, deal with apprehending
shoplifters. Check with you lawyer or the police in your
area.

GENERAL RECOMMENDATIONS. It is best to
apprehend shoplifters outside of the store. For one

thing, apprehension of this kind strengthens the store’s
case against a shoplifter. Then, too, scenes or any type
of commotion which a shoplifter precipitates interferes
with store operation.

You should recognize that apprehension in many
States does not necessarily have to be initiated outside
of the store. Sometimes, it suffices if a shoplifter is ob-
served concealing merchandise on his or her person. A
shoplifter is generally apprehended in the store if the
merchandise involved is of substantial value, and if you
feel that he may get away with the stolen goods if you
allow him to get beyond the store premises.

If the shoplifter is an elderly person, treat him or her
with extra gentleness lest he be ‘‘shocked.”’ If you
don’t, he may have a heart attack. A good approach to
stopping a suspect is to speak to him and identify your-
self. Then say: ‘‘I believe you have some merchandise
on your person or in your bag which you have forgotten
to pay for. Would you mind coming back to the store to
straighten out this matter?’’ Never touch the suspect
because the contact could be construed as roughness.

17

"B Ao whe magaynes, feprbackr books
anne Gnd tome back Ia dee td

Go

That's the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your Customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are yOur Operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

18 THE MARYLAND PHARMACIST

By Jake Miller, Pharmacist
Manager, Professional Relations
A.H. Robins Company, Inc.

Non-Traditional
Internship
Experiences

With the passing of summer, we have completed our
10th year of participation in the National Pharmaceutical
Council—Pharmaceutical Industry Summer Internship
Program. A. H. Robins was one of 22 manufacturers
taking part in the 1982 program conceived by the NPC
and the Student American Pharmaceutical Association.
The three interns who spent their summer with us were
among 87 students selected from 46 schools.

Each participating company sets up its own pro-
gram, with most consisting of rotation assignments
offering professionally supervised hands-on experience
in several departments. At A. H. Robins, each works
10 weeks in such areas as research and development,
quality assurance, production and marketing.

In addition to making students more aware of the
many jobs pharmacists perform in industry, this Pro-
glue provides an opportunity to gain a greater appre-

re OE woe NER ciation for everything that goes

“ intothe making of adrug. Thus,
the students will be better pre-
pared to make intelligent deci-
sions regarding drug sources
when they become practicing
pharmacists and will be better
able to explain the issue of
drug quality to their patients.

The program is one of
several which seeks to identify
non-traditional areas of professional pharmacy practice.
Other areas which may qualify for internship credit
include hospital pharmacy programs developed by the
VA; the U. S. Public Health Services’ COSTEP Training
program; national or state pharmaceutical association
internships; and participation in research programs
conducted under the auspices of manufacturers, col-
leges or governmental agencies which provide a learn-
ing experience comparable to professional practice and
which earn no academic credit.

As we have followed the careers of former NPC/
Industry interns, we have become firmly convinced that
the experience has been beneficial and we are proud to
have had a part in their professional development.

Intern Brian Bullock at work
in an A. H. Robins lab.
Bullock is current president
of the Student A.Ph.A.

A-H-POBINS

A. H. Robins Company
Richmond, Virginia 23220

OCTOBER, 1982

Though not dramatic, the use of pharmacy com-
puter systems is continuing its steady growth. In a little
more than a year, two dozen new firms have come into
the marketplace, while a significant number have left
this increasingly crowded field. The American Pharma-
ceutical Association’s (APhA’s) Pharmacy Manage-
ment Institute has identified about 90 primary suppliers
who have several hundred offices throughout the
country.

Pharmacy managers continue to fill computer sys-
tem conferences to capacity. There does not, however,
seem to be the degree of skepticism that was evident
before as pharmacy managers continue their search
for a solution to paperwork headaches and the cost-
price squeeze. This change in thinking is probably a
result of more information being available in the form
of conferences, articles in the literature, and the emer-
gence of Computer Talk for Pharmacists, a relatively
new source of pertinent information on pharmacy
computer systems.

APhA has a long-term interest in pharmacy systems
and has been of major service to pharmacists by pre-
senting programs on computers, providing information
to members, and advising computer vendors on how to
design their systems and service networks in response
to pharmacists’ needs. The Pharmacy Management
Institute has updated and consolidated its popular com-
puters bibliography. This comprehensive list has been
requested by more than 3,000 and is available without
charge from the APhA Pharmacy Management Insti-
tute, 2215 Constitution Avenue, NW, Washington, DC
20037, by sending a stamped, self-addressed envelope.

APhA is the national professional society of pharma-
cists. Its more than 50,000 members represent prac-
titioners in a variety of settings, pharmaceutical scientists,
pharmacy educators, and pharmacy students.

calendar

November 4—7—SAPhA Regional Convention,

Baltimore

November 7—**OTC Counseling’’ Crystal City, Mar-
riott

November 14—*‘ Diabetes’? Columbia Hilton, CECC
Program

November 14—Alumni Association Dinner Meeting

November 30—‘**Vitamin Marketing’ Atlantic City,
New Jersey

February 13—-BMPA Dinner Dance

March 13—**Communications and the Elderly’’ Cen-
ter for Aging, MPhA

March 27—‘‘Arthritis’> Ramada Inn, Baltimore,

CECC Program

19

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Information Information

District Wholesale Drug Corp.
7721 Polk Street
Landover, MD 20785
(301) 322-1100

Loewy Drug Co.
6801 Quad Avenue
Baltimore, MD 21237
(301) 485-8100

Spectro Industries, Inc.
Jenkintown Plaza
Jenkintown, PA. 19046
(215) 885-3676

Divisions of

SEPARATE BUT EQUALLY
INDISPENSABLE.

ty

Nei Sod BE) Co ee

at
Pre ln Yollmy o rie
rrr OE

Now more than ever, patients are turning to their
pharmacists for advice about drug products. That's
why more pharmacists around the country turn to
USP Dispensing Information (USP DI) as the definitive
reference for drug use information. Now the United
States Pharmacopeia is offering a newly expanded
and updated edition, available for the first time as
a two-volume set.

Volume |, designed for use by the pharmacist, con-
tains detailed dispensing information on over 4,500

= | hg . 3 de & uC & ys Roe ee! Le

Please send me the following:
Quantity

1983 USP DI, each complete two-volume set, $37.95. *

Se ee
Advice for the Patient

drug dosage forms and brands. Volume II is a corres-
ponding lay language guide for patients with instruc-
tions on the proper use, precautions and side effects
of their medicines.

In addition to the new two-volume D/, USP is
offering the consumer paperback About Your
Medicines and a free kit of advertising and publicity
tools to help you promote your patient education pro-
Biel To order your copies, just mail in the coupon
below.

MAIL TO: Maryland Pharmaceutical Association

650 W. Lombard Street
Baltimore, Maryland 21201

Additional copies of USP D/ Volume ||, Advice for the Patient, at $17.95* each.
About Your Medicines Consumer Display Kit (12 lay language paperback books packaged in counter-top display

box), $36.00. (Suggested retail price $4.95.)

1980 USP XX - NFXV, $75.00* *; or $100.00* * with annual supplements.

________ Free Patient Education Program Promotion Kit.
Total Cost $

. Enclosed is my check or money order for $

payable to USP, or charge my order to:

OVISA O MASTERCARD AccountNumbe: I LILIUVIUOIUODOUODDOOOOOU

Expiration Date: Signature:
SEND TO: ADDRESS:
ALY: STATE: 721/22

*Maryland residents add 5% sales tax. **Pennsylvania residents add 6% sales tax. 1983 USP Dis will be shipped in July 1982.

2 Gael ae Ge eas Es Be ee

i

ae
He 4 Hf
|

tia Lal ‘ yin URE

Research Roulette

In 1981, the cost of developing a new chemical entity was $77 million. Yet, three out of
four new chemical entities marketed never recapture their R & D investment.

Surprising? Yes. But, the real surprise is that today’s drugs consume only 8 percent of all
health care costs as compared with 16 percent 40 years ago.

Lilly Eli Lilly and Company

Indianapolis, Indiana 46285

200617

© 1982, EL! LILLY AND COMPANY

LETTERS

Dear Mr. Banta:

The Following is a continuing education conference
being conducted by the Medical College of Virginia,
School of Pharmacy.

‘‘Management of GI Disorders in the Elderly”’
Sunday, November 21, 1982

Hotel Roanoke

Roanoke, Virginia

CONTACT: Dr. Werner Lowenthal, Director
Continuing Education
School of Pharmacy
(804) 786-0334

We would appreciate having this announcement
published in your next issue of your journal.

Thank you for your assistance.
Sincerely,

Werner Lowenthal, Ph.D.
Director, Continuing Education

To the Maryland Pharmaceutical Association,

Thank you once again for your continued support of
SAPhA. We greatly appreciate all that you have done
for SAPhA in the past and look forward to working with
you in the future.

Each of the students attending the convention
learned many things about their future profession and
themselves.

Thank you again for your support.

Sincerely,
Cheryiel Betz
President SAPhA

Dear Mr. Banta:

Since you previously contacted the Presidential
Task Force on Regulatory Relief concerning patient
package inserts (PPI’s), the Vice President has asked
me to advise you that the Food and Drug Administra-
tion has issued a final rule effective today revoking
these requirements.

This action is being taken because the agency has
determined that a mandatory pilot PPI program is un-
justifiable, and that it is now preferable to encourage
alternative patient information efforts. The agency also
believes that cooperation with health professionals and
others in both the public and private sectors and reli-
ance upon expanding privately sponsored initiatives in
patient education will serve to provide patients with
needed information about prescription drugs.

OCTOBER, 1982

On behalf of Vice President Bush, may I again thank
you for making your views known to the Task Force on
this important issue.

Sincerely,

C. Boyden Gray
Counsel to the Vice President

Tel Med Cancer Series

One out of every six deaths in America this year will
be caused by cancer. But Marylanders will soon be re-
ceiving extra help in learning how to prevent, detect and
treat the disease. Seven Maryland Tel-Med free tele-
phone health information programs are featuring special
messages directing callers to contact the Cancer Infor-
mation Service at Johns Hopkins Oncology Center.

The Cancer Information Service is sponsoring the
pilot project using the Tel-Med communication network
in Maryland to disseminate information about the avail-
ability of additional cancer resources to the public.
Through the service callers will be able to receive in-
formation about cancer causes, prevention, early de-
tection, treatment, rehabilitation and referral to cancer
related agencies and services.

To receive the information, callers should ask for
the following Tel-Med tapes by number: 6-Breast
Cancer, 176-Cancer of the Prostate Gland, 179-Lung
Cancer, 180-Cancer of the Colon & Rectum, 181-Cancer
the Curable Disease, 183-Cancer’s Seven Warning Sig-
nals, 185-Cancer of the Skin, 186-Uterine Cancer,
$021-Cancer Information Service.

The numbers to call in Maryland are:

Allegany County: Sacred Heart Hospital, 777-8383
Baltimore: University of Maryland Hospital, 528-3111
Provident Hospital, 728-2900
Lower Shore: Peninsula General Hospital in Salisbury
(after October 1, 1982)
Montgomery County: Shady Grove Adventist Hospi-
tal, 424-7500

Prince George’s County: Prince George’s Library,
345-4080 or TTY for the
deaf, 345-0800

Upper Shore: Memorial Hospital at Easton, 822-9198

Short and sweet is better
than long gone

Often the more words you write, the less clear your
message becomes. Take for example, this list, compiled
by Grassroots, of the number of words in these writings
from the past.

The Lord’s Prayer, 56 words.

The Gettysburg Address, 266 words.

The Ten Commandments, 297 words.

The 23rd Psalm, 118 words.

The 1966 U.S. Government Order on Cabbage
Prices, 26,911 words.

ee

Art Prints Available
Maryland Pharmacy History

The Centennial Committee of the Association has commissioned a limited set of art prints depicting
historical sites in Maryland. These prints by noted artist Marian Quinn are each hand numbered and
signed by the artist. The prints are available from the Association Office at $7.50 each or four for
$25.00. They are ink line drawings that are certain to be collectors items in the future.

ee

MARYUAND COLLEGE OF PHARMACY
aoa

UNIVERSITY OF MARYLAND SCHOOL OF PHARMACY
BALTIMORE 1877- 1886

E.W. STERLING PHARMACY, CHURCH HILL, MD
BUILT IN 1895

KELLY MEMORIAL BUILDING, BALTIMORE
BUILT IN 953

| |
f (Order Form) art print order form |
q 1
q |
5 Name |
i |
i Address P
q |
| I
i Phone '
u |
fl Number of Prints at $ is $_____ Total enclosed r
| |
d d
a (Prints are $7.50 each or four for $25.00) |
: Mail this form and check made payable to MPhA to 650 West Lombard St., Baltimore, Maryland :
21201.
| i

Pharmacists, Clergy Rated
Highest on ‘Ethics Scale’

By George Gallup

Clergymen and pharmacists are rated highest by the public in terms of ‘‘honesty’’ and
‘‘ethical standards’’ among 24 professions and occupations tested.

These findings are based on the third Gallup study of public perceptions of the ethics of
persons in a wide range of professions. This question has been asked in each survey:

How would you rate the honesty and ethical standards of people in these different
fields — very high, high, average, low, or very low?

While certain professions or occupations do not fare too well in these studies, it is im-
portant to bear in mind that these findings reflect public perceptions only and are not
necessarily a true indication of the ethical standards of a particular group.

At the same time, however, the findings suggest the need for a strong public relations
effort on the part of certain professions or occupations.

Clergy Again Top List
Next Are Pharmacists

Clergymen, as in the two earlier surveys, come out on top of this ‘‘ethics scale,’’ with
63% of persons in the survey giving them either a very high or high rating.

Next are pharmacists with a positive range of 59%.

Following closely are dentists, medical doctors, engineers, college professors, and
policemen, with overall positive ratings ranging from 52 to 44%.

The next highest groups include bankers, TV reporters or commentators, newspaper
reporters, and funeral directors, with positive scores ranging from 39 to 30%.

Maryland Pharmaceutical Association

When

was the

last time
your
insurance
agent

gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville, Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
BERNARD B. LACHMAN EVERY YEAR!
Usually for more than 20% of his premium.

BUNKY is one of the many Maryland pharma-
cists participating in the Mayer and Steinberg/
MPhA Workmen’s Compensation Program—
underwritten by American Pruggtts
Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS...
call or write:

Your American Druggists’ Insurance Co. Representative

AMERICAN
Ane DRUGGISTS’
INSURANCE

Please contact me. | am interested in receiving more
information about the Mayer and Steinberg/MPhA Workmen's
Compensation Program. O Call O Write.

Beverly Litsinger, MPhA Office Secretary, works with the new BMPA President Frank Marinelli discusses plans with SAPhA
word processor recently purchased by the Association. The ma- President Cheryl Betz.

chine will improve staff efficiency and allow the Association to

provide better service to the members.

BMPA President Marinelli (right), SAPhA Chapter Advisor Donald Held in the Kelly Building, the Luncheon produced a record turn-
Fedder (center), and BMPA President-Elect Elwin Alpern, were out of students, faculty and friends.

among those who attended the September 7th SAPhA Luncheon.
The event was sponsored by the BMPA as part of a membership
recruitment drive by the student organization.

This page donated by
District-Paramount
Photo Service.

DISTRICT PROTO Int

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

Pictures courtesy Abe Bloom — District Photo

OCTOBER, 1982 27

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

ASPIRIN:

Aspirin remains the drug of choice for treating
rheumatoid arthritis. Although the drug certainly causes
gastrointestinal distress, its effect on the renal system
over a long period of time is less clear. Studies from
various sources tend to clear aspirin of causing renal
damage, even when used for prolonged periods. Renal
toxicity is more apparent when agents such as phenace-
tin are used with the salicylates. J Am Med Assoc, Vol.
D4 Le Das DL Osen Ore

LEGIONNAIRES DISEASE:

Since it was originally characterized in 1976, much
of the information concerning Legionnaires disease has
been obtained by studying patients with the disease.
The organism responsible for causing this condition,
Legionella pneumophilia, does not infect animal lungs
as it does the human respiratory tissue; thus animal ex-
perimentation is minimal. Furthermore, when injected
intraperitoneally the organism does not infect respira-
tory tissue so only extrapulmonary sites of infection can
be studied. Experiments recently conducted indicate
that respiratory infections similar to those seen in
human lung tissue can be induced in guinea pigs using
aerosols containing the organism. This allows for suit-
able experimental animal models to be used to study the
effect of this organism in respiratory tissue. Lancet,
Vol. H, #8260, p. 1389, 1981.

NSAID:

Drugs belonging to the group designated as non-
steroidal, anti-inflammatory drugs (NSAID) are thought
to have many similar pharmacological effects due to
their common ability to inhibit the synthesis of prosta-
glandins. Experiments in animals indicate that these
agents may have different effects on regional circula-
tion. For instance, mesenteric vasculature is constricted
by indomethacin (Indocin) but not by ibuprofen (Mot-
rin). The authors hypothesize that the action of in-
domethacin is characteristic of the drug itself and is not
due to its ability to inhibit prostaglandin synthesis. J
Pharmacol Exp Ther, Vol. 219, #3, p. 679, 1982.

IBUPROFEN:

Ibuprofen (Motrin) is a potent inhibitor of prosta-
glandin synthesis. Since prostaglandins have been said
to have a role in regulation of coronary artery tone, this
NSAID was examined in perfused animal heart tissue to
see if it might have an effect on coronary flow. It ap-
pears that ibuprofen will cause coronary dilation but it
acts in a way not associated with inhibition of prosta-
glandin synthesis. J Pharmacol Exp Ther, Vol. 220, #1,
p. 167, 1982.

28

GUANABENZ:

Guanabenz is an experimental antihypertensive
agent which acts centrally to reduce adrenergic outflow
from the central nervous system. The drug does not
cause volume expansion and thus investigators have
considered it for use as a sole agent for treating mild
hypertension. Wyeth Laboratories is conducting re-
search with this new drug. Clin Ther, Vol. 4, #4, p. 275,
LOST.

RAYNAUDS DISEASE:

Patients with Raynauds disease, especially if com-
plicated by collagen disease, experience coldness in the
hands which is often difficult to correct. In order to
increase circulation through the extremities without re-
sorting to systemic therapy, nitroglycerin ointment was
applied to the hands. Results were compared to those
obtained after lanolin application. Topical application of
nitroglycerin produced beneficial results in this study
and thus certain patients with Raynauds disease may
experience relief without having to resort to more in-
tense therapy. Lancet, Vol. 1, #8263, p. 76, 1982.

SISOMICIN:

Sisomicin is an aminoglycoside antibiotic which has
been used experimentally for several years. Its activity
against serious Gram negative infections was compared
to that of gentamicin (Garamycin) in 101 hospitalized
patients. Sisomicin produced a 93% reduction in patho-
gen population while gentamicin affected only 67% of
the group examined. Sisomicin is being tested by the
Schering Corporation. Clin Ther, Vol. 4, #4, p. 263,
1982.

PLASTIC STRIP THERMOMETERS:

An experiment was designed to compare a plastic
strip thermometer with the conventional mercury/glass
apparatus. In a group of 613 patients, the older ther-
mometer produced more accurate readings than did the
plastic strip model. Variations in ambient temperature
can alter the readings taken by the newer apparatus and
thus the chance for inaccuracy is increased. J Am Med
Assoc, Vol. 247, #3, p. 321, 1982.

ARTHRITIS:

Salicylates and NSAID have long been considered
the first line of therapy against arthritis, but resistant
cases require more intense therapy. Patients who dis-
continued taking a second-line drug such as gold,
penicillamine (Cuprimine) or levamisole because of
toxicity were given another of these agents to see if they
might be better tolerated. Follow-up studies indicate
that if toxicity to one drug in the group becomes un-
bearable, an alternate should be tried before resorting to
even more drastic therapy. Br Med J, Vol. 284, #6309,
p. 79, 1982.

THE MARYLAND PHARMACIST

AMILORIDE-DIGOXIN INTERACTION:

Amiloride (Midamor) is a recently introduced
potassium-sparing diuretic which most likely will be
used in combination with a thiazide diuretic rather than
by itself. Since thiazide diuretics can produce potassium
depletion, the combination may be quite useful in pre-
venting hypokalemia. This would be of special interest
to patients with congestive heart failure who are re-
ceiving digoxin. Preliminary studies indicate that
amiloride prevents the positive inotropic effect pro-
duced by digoxin thus reducing its value in this disease.
Additionally, these investigators feel amiloride may en-
hance the renal secretion of digitalis glycosides. Drug
Ther, Vol. 7, #1, p. 51, 1982.

ACYCLOVIR:

A new antiviral agent, acyclovir (Zovirax) is said to
have the potential to do for antiviral therapy what
penicillin did for antibacterial therapy. The drug is said
to be especially useful in controlling herpes infections
and the manufacturers are optimistic about its accep-
tance by the general medical community as the first
such agent with major selectivity against the virus. FDC
Rep, Vol. 44, #14, p. 8, 1982.

MINOCYCLINE:

Minocycline (Minocin) is unique among tetracycline
derivatives in that it is more lipid soluble at physiologi-
cal pH than others congeners and thus is able to pene-
trate tissues to a greater extent than other agents in that
class. The metabolism of minocycline has been studied
and it appears that thre major metabolites can be iso-
lated. This study represents the first indepth investiga-
tion into tetracycline metabolism using a new technique
which may be of value in determining the metabolites of
other derivatives. Drug Metab Dispos, Vol. 10, 32, p.
142, 1982.

METOCLOPRAMIDE:

Patients being treated with potent emetogenic an-
tineoplastic agents, e.g. cisplatin (Platinol) were given
metoclopramide (Reglan) intravenously to reduce the
incidence of nausea and vomiting associated with che-
motherapy. The drug worked well without producing
significant side-effects. J Am Med Assoc, Vol. 247,
#19, p. 2683, 1982.

DIAZEPAM:

Oral contraceptives and benzodiazepine derivatives
are among the two most commonly used drug groups
prescribed for use in young women. Studies in women
taking one or both of these drug types suggest that low
dose estrogen containing oral contraceptives may
interfere with the metabolism of diazepam (Valium).
The interaction is of significant magnitude to strongly
suggest that it be watched for in women taking both
drug types. N Engl J Med, Vol. 306, #13, p. 791, 1982.

OCTOBER, 1982

GINGER:

As far back as 1597, the fluid extract of the rhizome
of ginger (Zingiber officinale) was used to mitigate
symptoms of gastrointestinal distress. Experiments
conducted in volunteers suggest that the powered
rhizome of ginger was superior to dimenhydrinate
(Dramamine) and placebo in protecting against motion
sickness induced via artificial means. Lancet, Vol. I
#8273, p. 655, 1982.

PHENYTOIN LEVELS:

Patients with epilepsy require less phenytoin to
maintain plasma levels of 15 ug/ml as they age. When
compared to those in the age bracket between 20 and 39
years, it was noted that a reduction in dosage amounting
to 21% was required for those aged 60 to 79 years in
order to prevent toxicity. Clin Pharmacol Ther, Vol. 31,
#3, p. 301, 1982.

HEROIN:

Heroin has been used in Great Britain for analgesia
associated with neoplastic disease, but its advantage
over morphine is obscure. Studies conducted at
Georgetown University and at the Sloan Kettering In-
stitute indicate that although heroin is more potent than
morphine milligram per milligram, its overall efficacy as
an analgesic is comparable. The American Medical As-
sociation opposes legalization of heroin and this study
tends to support that view. J Am Med Assoc, Vol. 247,
#18, p. 2471, 1982.

PIRETANIDE:

A new potent diuretic, piretanide, was administered
for six weeks, at times in conjunction with digoxin
(Lanoxin). No variation in plasma potassium levels
were noted although a potent diuretic effect was ob-
served. Longer studies are needed to substantiate the
lack of potassium depletion said to be associated with
the drug. .Clin Pharmacol Ther, Vol. 31, #3, p. 339,
1982.

CIMETIDINE:

Patients given cimetidine often experience resolu-
tion of duodenal ulcers, but no information was avail-
able to suggest what effect continued therapy might
have on relapse rates. Studies using one gram of the
histamine-2 antagonist daily for a time after healing has
occurred indicates that there is no assurance against a
relapse once the drug is discontinued. Br Med J, Vol.
284, #6316, p. 621, 1982.

CYCLOSPORIN A:

A new antirejection drug is thought to be superior to
all other immunosuppressants available to date. Cy-
closporin A produces its beneficial effects without pro-
ducing the degree of toxicity associated with other
agents. This year the first single lung transplant is
scheduled to take place and the use of cyclosporin A
figures prominently in the proposed positive outcome. J
Am Med Assoc, Vol. 247, #17, p. 2331, 1982.

29

Our best
friends are our
severest critics
and our greatest
assets.

Meet our 1982 Pharmacy Consultant Panel.

Stephen D. Roath, R.Ph
Vice President, Director of
Professional Affairs,
Longs Drug Stores, Inc
Walnut Creek, California

Marilyn Slotfeldt, Pharm.D.
Clinical Services
Good Samaritan Hospital
Portland, Oregon

Harland W. Henry, R.Ph

Director of Pharmacy

Memorial Hospital System
Houston, Texas

i Harold H. Wolf, Ph.D.,R.Ph

Dean, College of Pharmacy
University of Utah
Salt Lake City, Utah

H. Joseph Schutte, R.Ph
Community Pharmacist
Louisville, Kentucky

Donald Hoscheit, R.Ph
Vice President, Pharmacy
Osco Drug, Inc
Oak Brook, Illinois

Lawrence A. Diaz, R.Ph
Community Pharmacist
Gainesville, Florida

sional and other pertinent
matters are invaluable.

cs ee RERGUL EAA E Ph Their advice and coun-

Louis M. Sesti, B Ph Director of Pharmacy sel helps us serve you bet-
Michigan Pharmacists Association DaNers ty Ol Maniendsosnilales jiter.ingthesexpand i Cimmmse
Lansing, Michigan US eye

Martin Lambert, Ph.D.,R.Ph
Community Pharmacist

Knoxville

Tennessee

No diplomatic double talk.
We need the advice of
pharmacists in order to do
a better job for pharmacists
The bad news and the good.
That's what the ten mem-
bers of our 1982 Pharmacy
Consultant Panel provide
Their views on profes-

of pharmacy.

| Upjohn | Kaenaae hatcnarapoole
Kalamazoo, Michigan 49001

Classified Ads

Classified ads are a complimentary
service for members.

WANTED

Individuals interested in serving on the Association’s Rehabilita-
tion Committee. Contact the Association office for details.

Pharmacist: Part time relief work in Hancock area, excellent
salary, flexible hours, pleasant working conditions, no front end
responsibilities. For more information call Jim Kirkwood. collect
717-761-0910

RECENTLY RETIRED PHARMACEUTICAL SALESPEOPLE wanted
for consultant part-time positions. For further details please
call Al McConnell, any Friday, collect, at (703) 435-0643.

PHARMACY FOR SALE

Ideal location on corner lot downtown Bel Air, one block from
new Court House and one block from new State office building.
Modern brick building, 8474 Sq. ft. floor space on two floors.
Owner will sell real estate, business, inventory and equipment.
Priced to sell. Worth looking into. Contact Charles V. Spalding,
Realtor, at 879-2500.

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

HOTLINE NUMBERS FOR
IMPAIRED PROFESSIONALS
467-4224
796-8441
685-7878
467-3387

Physicians —
Dentists

Attorneys

Nurses

OCTOBER, 1982

PERSONAL MEDICATION RECORD

Prepared by ELDER-ED
University of Maryland School of Pharmacy
636 W. Lombard St. Baltimore, Md. 21201

With a grant from Parke-Davis
Division of Warner-Lambert Company
This Medication Record is available at no charge from either the

Association office or the Elder-Ed Program for distribution to
your patients. Call and order yours now.

We at SELBY DRUG COMPANY
attribute our rapid growth and success
to our ability to make changes. These
changes are made rapidly, when and
where they are needed!!

The SELBY DRUG management

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DO YOU?????

Maybe it’s time for you to evaluate
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For information on our Full Line pro-

gram, please call person-to-person collect
to:

Wallace Katz
Senior Vice President

SELBY DRUG COMPANY

633 Dowd Avenue
Elizabeth, NJ 07201
(201) 351-6700

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INDEPENDENT
PHARMACISTS’
ASTRO SURVIVAL KIT

e GROUP BUYING POWER
e PERSONALIZED CIRCULARS AT PEAK SELL PERIODS
¢ GOOD MERCHANDISE MIX «© COMPETITIVE PRICING

e RADIO PROMOS ¢ WINDOW SIGNS ¢ POINT OF SALE SIGNS
e MFGS. ACCRUED CO-OP ADVERTISING ALLOWANCES!

ASTRO IS ON THE MOVE!

For information on our complete advertising program - phone 467-2780

THE DRUG HOUSE 9O1 CURTAIN AVE., BALTO., MD. 21218
INC. Ask for Gary McNamara

An Alco Standard Company

Maintaining Financial Strength )
——— Bruce Seicker, Ph:D.

New Penalties eel by Board of Pharmacy
Consumer Attitudes About Pharmacists

ANTIGUA

January 23-30, 1983

SS at “, :

i = as

Improving Your Future es :
APhA’8 ze we
by, ) CAIs

kK

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Professional Investment

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130th Annual Meeting

American Pharmaceutical Association
April 9-14, 1983

New Orleans, Louisiana

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THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 Nee

NOVEMBER 1982 VOL. 58 NOSUL

DAVID A. BANTA, Editor

CONTENTS BEVERLY LITSINGER, Assistant Editor

ABRIAN BLOOM, Photographer

3 President's Message Officers and Board of Trustees
1982-83

intaining Financial Strength Honorary President
4 Mainta 8 8 WILLIAM J. KINNARD JR., Ph.D. — Baltimore
— Bruce Siecker, Ph.D.

President

MILSON SAPPE, P.D. — Baltimore
7 A Maryland Tradition — William Skinner, P.D. Vice-President

WILLIAM C. HILL, P.D. — Easton

Treasurer

10 New Penalties Proposed by the Board of Pharmacy MELVIN RUBIN, P.D. — Baltimore

Executive Director

17 A Brief History of USPHS Pharmacy in Maryland _ DAVID A. BANTA, C.A.E. — Baltimore

= George F. Archambault Executive Director Emeritus
; NATHAN GRUZ, P.D. — Baltimore

21 Consumer Attitudes About Pharmacists

TRUSTEES
PHILIP H. COGAN, P.D. — Chairman

28 Abstracts ane
RONALD SANFORD, P.D. (1985)
Catonsville

PARTMENTS

DEPA JAMES TERBORG, P.D. (1985)
Aberdeen

31 Calendar GEORGE C. VOXAKIS, P.D. (1984)
Baltimore

: BARBARA BARRON, P.D. (1983)

31 Classified Ads Rising Sun, Maryland
CHERYL BETZ, SAPhA (1983)

20 Letters to the Editor Baltimore

EX-OFFICIO MEMBER
WILLIAM J. KINNARD, JR., Ph.D. — Baltimore

ADVERTISERS

6 Abbott

Maryland News Distributing HOUSE OF DELEGATES

8-9 Boots 18 Mayer and Steinberg ae

27 District-Paramount Photo 19 Parke Davis BORN SS . :
ay eThe Dre House 3098 PMACOnpany STANTON BROWN, P.D. — Silver Spring
14 Eli Lilly and Co. 22 Upjohn Vice Speaker

23 Loewy Drug Company HARRY HAMET, P.D. — Baltimore

MARYLAND BOARD OF PHARMACY
Honorary President

Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN, P.D. — Salisbury
new address with zip code number. Allow four weeks for changeover. APhA member — :
please include APhA number. President

BERNARD B. LACHMAN, P.D. — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore
part of their annual membership dues. Entered as second class matter at Baltimore, Mary- ANTHONY G PADUSSIS P.D. — Timonium

land and additional mailing offices. Postmaster: send address changes to: The Maryland

Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201. PAUL FREIMAN, P.D. — Baltimore

PHYLLIS TRUMP, B.A. — Baltimore

2 THE MARYLAND PHARMACIST

President's Message

Presidents, Executive Directors, Members, dues. An Association is
made up of none of these. It is through working together, group participation
and service that an association takes character and represents what its members
want it to be. It must have been this way when pharmacists came together to
form this Association 100 years ago. They had the idea that forming a union of
pharmacists made them stronger and better able to confront the problems of
their day. Problems although different are with us today and will be tomorrow.
A strong association must be supported by willing members. When I use the
phrase ‘willing member’ I mean a person who consciously realizes what this
Association is trying to do for him or her. The signing of a check, the forwarding
of dues should not be a perfunctory act but a realization that this money is a fee
for services rendered. Services that affect all aspects of our professional lives
such as continuing education, third party monitoring, legislative lobbying, peer
review, impaired pharmacist aid, a working relationship with our school and
etc., etc., etc. If you had to pay for these services with a flat rate or by the hour
your fee might be astronomical. The fee is more than reasonable only because
most of the services are accomplished with volunteer help. I used the term fee
for service before but it is not even that, it is an investment in the present and
the future. Try not to think that your dues check is your only connection with
the Association. I know that not everyone is cut out to give hands-on help, still
there are many ways to participate. Do you know that less than half of our
members voted in the last election. Take some time to read The Maryland
Pharmacist and our bulletin. Take one continuing education course. Give us
some feed-back either through letters to be published in the Pharmacist or
notes to Dave or myself. Dues are important, bodies are important, but most
important is the back bone and spirit within an association that characterize its’

success and worthiness.

PRESIDENT

NOVEMBER, 1982

Maintaining Financial
Strength

by Bruce Siecker

The current recession has lasted so long and cut so
deeply that virtually every major sector of the economy,
region of the country, and type of worker has been af-
fected. The slump—made worse by cutbacks in
Medicaid spending—has hurt community pharmacies in
every part of the country. Even large chain pharmacies
have felt the pinch as consumer spending has softened.

Few pharmacies have well thought out financial sur-
vival plans for bad times. When trouble develops, inde-
cision and seat-of-the-pants management prevail. As a
result, too little is often done too late! Unprepared com-
panies fail to realize the trouble they are in until a major
crisis develops. Others plunge ahead on the vague as-
sumption that things will somehow get better on their
own. Tentative leadership and unfounded optimism
often prove disastrous, even when a pharmacy appears
to be financially healthy.

Pharmacies that survive the current recession will
be those that are lucky or implement decisive actions to
preserve their financial strength. Maintaining a strong
financial base is the key challenge facing today’s phar-
macy manager. Meeting that challenge requires serious
attention, tough choices, and decisive action. Those
who meet the test will be poised to take full advantage
of the eventual recovery.

Many factors affect how well a pharmacy does fi-
nancially, and today’s manager can afford to ignore
none of them. But three of them demand constant vigil:
reducing costs, controlling inventory, and improving
cash flow.

Below are dozens of ways other pharmacies are
facing the need to manage boldly and aggressively.
Some may not apply to you. On the other hand, do not
dismiss any of them without some forethought. Each
idea provides some help; used together they can provide
very powerful help to maintain a pharmacy’s financial
strength.

Reducing Costs

e Provide incentives to employees for ideas to re-
duce costs.

@ Promote from within rather than hire from out-
side to save money and improve staff morale.

“By Bruce R. Siecker, Ph.D., Director, APhA Pharmacy Man-
agement Institute, 2215 Constitution Avenue, NW, Washington, DC
20037.

4

@ Develop a list of ‘‘idle time’ tasks that will make
better use of existing personnel.

e Conduct inhouse training to improve employee
skills. Focus on ways employees can help reduce costs
and cross-training.

e Consider sub-leasing pharmacy space that is not
producing adequately to a related operator.

e Ask the local utility to conduct an energy audit to
reduce energy consumption.

e Defer making computer software and hardware
changes unless they pay off quickly with reduced costs.

e Monitor mailing practices for opportunities to
save money. Check into second and third class.

e@ Use white envelopes for all classes of mail; postal
workers tend to handle them as first class anyway.

e Determine whether long-distance costs can be
reduced by using alternate service suppliers.

e Increase security measures aimed at both inter-
nal and external theft.

@ Review advertising practices with a view of high-
est efficiency in reaching the desired audience.

e Determine whether new equipment, which is ab-
solutely essential, can be leased attractively to avoid
major capital outlays.

e@ Examine payroll costs and wage rates in lieu of
local conditions; consider the possibility of layoffs, re-
duction in wage or salary, and even permanent reduc-
tions in staff.

e Ask employees to suggest activities that can be
combined or eliminated. Pay particular attention to
similar and overlapping activities completed by differ-
ent employees.

@ Meet with key employees to get their ideas and
commitments to reduce costs.

e Review insurance costs, looking for coverage
that can be consolidated or reduced.

e Increase insurance deductibles to reduce pre-
miums.

e Assign someone to look critically at the ways
prescriptions are processed with the aim of reducing
wasted motion and activities.

e Use high-school students for housekeeping rather
than more expensive staff or a janitorial service.

e@ Review salary policy. Overtime merit raises and
bonuses tend to become automatic.

e Eliminate unnecessary local and out-of-town
travel.

THE MARYLAND PHARMACIST

e For necessary travel, investigate budget motels
and Super Saver rates. Use public or low-cost limo
transportation services when out of town.

e Study the amount of staff time dialing the thirty
most-frequently called numbers. The monthly cost of an
automatic dialing device may be less.

@ Get rid of all paperwork that is not essential, es-
pecially internal reports that no one reads and forms
that are rarely used.

e Monitor hourly sales activity to determine
whether pharmacy hours should be adjusted or staff re-
scheduled in response to changing sales patterns.

e Form a buying group to negotiate better terms
from local suppliers.

@ Decide whether you are getting your money’s
worth from the pharmacy’s accountant, banker, legal
and financial advisors.

e Talk with other pharmacy managers, and mana-
gers of related firms, to see how they are reducing costs.

Controlling Inventory

e Eliminate low-margin, slow-turnover items and
lines, e.g., items with turnovers of less than three and
margins of less than 30%.

e Investigate suppliers that offer consignment
terms.

e Limit promotional buying to those items nor-
mally carried in stock.

e Establish a maximum time any item can be in
stock before it is returned, sacrificed, or discarded, e.g.,
180 days.

e Hesitate to add new lines.

e Adopt demand purchasing where the demand for
the item and a target turnover determine how much is
stocked.

e Reconsider direct purchase habits for their im-
pact on increasing inventory levels because of high
minimums.

e@ Think more about the carrying cost of inventory;
carrying costs far exceed ordering costs in community
pharmacies.

e Consolidate purchasing with one wholesaler in
exchange for better terms and services.

e Study which lines respond best to price level;
consider discounting leading items in those lines to im-
prove inventory turnover and strengthen price image.

e Make sure the count is accurate. Check all in-
coming orders to be sure there are no shortages.

e Some suppliers attempt to improve their own
cash flow by delivering early. Institute a ‘‘start ship”’
practice, especially for seasonal goods, to show the first
date delivery will be accepted.

e Terminate all automatic shipment arrangements
for new items.

e Stop buying every promotional deal that is of-
fered. Deals increase inventory unnecessarily and pro-
duce a false sense of prosperity.

NOVEMBER, 1982

e Institute a program of regular physical counts.
Identify high cost items, then assign someone specific
responsibility to keep quantities at bare minimum.

Improving Cash Flow

e Establish a payment calendar so invoices are not
paid too soon.

@ Begin adding a service charge on inactive and
overdue receivable accounts.

e Divide receivable accounts into two groups; bill
one group every two weeks to smooth cash in-flow.

e@ Prepare accounts in descending dollar amounts,
rather than in alphabetical or account number order.

e@ Mail account statements as they are completed,
not waiting until they are all done.

e Use first-class postage on high-dollar accounts
receivable to speed delivery.

e@ Establish a faster schedule for submitting third-
party claims.

e Teach staff how to sell larger sizes and make
companion sales, thereby increasing average sales per
transaction.

e Eliminate all nonessential or low-value staff ac-
tivities so they can focus more attention on customer
service.

e Offer a discount for those who pay with cash.

e Have a sidewalk sale to clear out old stock, then
do not restock.

e Consider offering a discount on the purchase of
the second package of a given item.

e Defer nonessential capital investments.

e Partially or wholly replace cash bonuses and
awards with gifts of inventory or offer employee dis-
counts on purchases in lieu of cash awards.

e Ask your accountant whether depreciation
schedules can be accelerated.

e Examine records to see whether tax deductions
were missed.

e Be sure to take an investment tax credit on capi-
tal purchases. It may also be possible to get an invest-
ment tax credit on leased equipment if the lesser failed
to take one.

e Take a very hard, long look at the benefits and
costs of current delivery practices. Think about other
ways, a reduced service level, or even elimination of
delivery.

e Begin levying a delivery charge.

e Increase the charge for bad checks. Some banks
are now charging $10—15 per bounced check.

e As the inventory level is reduced, adjust insur-
ance coverage downward.

@ Pay all bills by check; make deposits in person.

e Attempt to negotiate special, longer payment
terms.

@ Watch the age of receivables closely. Establish
standard procedures and specific actions when account
is 30, 60, and 90 days overdue.

6

Thanks,

Albany College of Pharmacy

Albany, NewYork

ABBOTT

2043457

These young people recently spent a very full day
at Abbott, touching bases in research, development and
production.

Many of them were impressed— and said so— with
the hundreds of steps and precautions taken to assure a
top-quality product.

We were impressed, too— with them.

They were bright, curious, professional and very excited
about their careers.

It was a good day. And one way we know of starting —
and keeping — a dialogue.

THE MARYLAND PHARMACIST

A Maryland Pharmacy
Tradition

by William J. Skinner
Chairman, Centennial Committee

Among those sterling features which sets pharma-
cists of Maryland apart is their network of organization,
particularly in Baltimore. The Baltimore Veterans
Druggists’ Association is one of those ‘‘old boy”’ net-
works that has given much to the last 100 years. BVD’s
started in 1926 with Robert Edward Lee Williamson,
Andrew Grover DuMez and Charles Chaplan Neal as
officers. These gentlemen started a tradition which has
stayed together since then and grown despite the demise
of such groups around the United States.

The organization was originally limited to 25 phar-
macists who had 25 years each in pharmacy. The
monthly meetings started at the Rennert Hotel, made
famous over the years by Woodrow Wilson and H. L.
Mencken.

Because the organization was made up of veteran
(older) pharmacists it was natural that one of the ac-
tivities adopted consisted of all members attending the
funerals of departed brothers. A standard ceremony
was arranged and made part of the organization’s pro-
cedures.

While the primary objective was to promote good
fellowship among pharmacists, other activities included
annual Christmas donations to many groups in the Bal-
timore area. In 1950 the rules of the organization were
changed to permit active membership to increase to 75
and all associate members were made active.

To a man, every member of the BVDA was also
active in other pharmacy organizations, such as the
Alumni Association, the American Pharmaceutical As-
sociation, the National Association of Retail Druggists
and local chapters of the national groups. Among the
members were nonpharmacists, H. C. Byrd, the presi-
dent of the University of Maryland; Joseph F. Hindes,
chairman of the board of Emerson Drug Company and
pharmacists who had not practiced in the community
area, including Charles C. Neal, general manager of
Sharp & Dohme, William C. McKenna of the Baltimore
Drug Exchange and R. S. Fuqua, the chief pharmacist
of the Johns Hopkins Hospital.

In 1976, 31 of the members assembled for the 50th

The author is indebted to Dr. Charles E. Spigelmire and Dr.
Stephen Provenza for information about the BVD’s.

NOVEMBER, 1982

MARYLAND
PHARMACEUTICAL
ASSOCIATION

anniversary at the Victorian Room of the apartments in
Baltimore. President that year was Samuel P. Jeppi and
secretary-treasurer was Dr. Benjamin F. Allen. Other
recent officers have included Charles E. Spigelmire,
president; Samuel A. Goldstein, Ist vice president;
Alexander M. Mayer, 2nd vice president; Edward W.
Piper, assistant-secretary-treasurer and Godfrey D.
Kroopnick, recording secretary.

Certainly the BVDA is one of Maryland’s most in-
teresting pharmacy traditions and one that we can all be
proud to see continue through the next 100 years of
Maryland pharmacy.

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a program that teaches your
employees how to make their
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not to get mugged.

So take the time, and...

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Write to McGruff, Crime Prevention Coalition,
20 Banta Place, Hackensack, NJ 07601 for
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A message from the Crime Prevention Coalition,
a @§j this publication and The Ad Council

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For Your Information

New Penalties Proposed
by Maryland Board of Pharmacy

.01 Scope.

These regulations establish standards for the impo-
sition of penalties not exceeding $5,000 against any
pharmacist or pharmacy permit holder in the State if,
after a hearing, the Board finds that there are grounds
under the Health Occupations Article, §§$12-311 or 12-
409, respectively Annotated Code of Maryland, to sus-
pend or revoke a license or pharmacy permit.

.02 Definitions.

A. ‘‘Board’’ means the State Board of Pharmacy.

B. ‘‘License’’ means, unless the context requires
otherwise, a license issued by the Board to practice
pharmacy.

C. ‘‘Penalty’’ means monetary penalty.

D. ‘‘Pharmacy permit’? means a permit issued by
the Board to establish and operate a pharmacy.

.03 Imposition of a Penalty Generally.

After a hearing pursuant to the Health Occupations
Article, §§12-312 or 12-410, Annotated Code of Mary-
land, the Board may impose a penalty against a pharma-
cist or pharmacy permit holder for violation of the
Health Occupations Article, §§12-311 or 12-409, re-
spectively:

A. Instead of, or in addition to, suspending a license
or pharmacy permit, or

B. In addition to revoking a license or pharmacy
permit.

.04 Imposition of Penalties on Pharmacists.

A. A penalty of not less than $100 or more than
$2,000 may be imposed by the Board on a pharmacist
found guilty of any of the following:

(1) Willfully makes or files a false report or rec-
ord as part of practicing pharmacy;

(2) Willfully fails to file or record any report that
is required by law;

(3) Willfully impedes or obstructs the filing or
recording of any report that is required by law;

(4) Willfully induces another to fail to file or re-
cord any report that is required by law;

(5) Violates any provision of the Maryland
Pharmacy Act, §12-510, Annotated Code of Maryland,
which concerns the labeling requirements for prescrip-
tion medicines;

10

(6) Advertises or otherwise publicly claims to
prepare or fill prescriptions in a superior manner;

(7) Advertises in a manner that tends to deceive
or defraud the public; or

(8) Is physically or mentally incompetent.

B. A penalty of not less than $200 nor more than
$3,500 may be imposed by the Board on a pharmacist
found guilty of any of the following:

(1) Provides or causes to be provided to any au-
thorized prescriber prescription forms that bear the
name, address, or other means of identification of a
pharmacist or pharmacy;

(2) Splits or agrees to split fees for professional
services with an authorized prescriber;

(3) Agrees with an authorized prescriber to pre-
pare or dispense a secret formula prescription; or

(4) Accept as to an association that has remained
in continuous existence since July 1, 1963, associates as
a partner, co-owner, or employee of a pharmacy that is
owned wholly or substantially by an authorized pre-
scriber or group of authorized prescribers.

C. A penalty of not less than $500 nor more than
$5,000 may be imposed by the Board on a pharmacist
found guilty of any of the following:

(1) Fraudulently or deceptively obtains or at-
tempts to obtain a license for the applicant or licensee or
for another;

(2) Fraudulently or deceptively uses a license;

(3) Aids an unauthorized individual to practice
pharmacy or to represent that the individual is a phar-
macist;

(4) Is addicted to any controlled dangerous sub-
stance or habitually is intoxicated;

(5) Provides pharmaceutical services while intox-
icated or under the influence of a drug with abuse po-
tential;

(6) Without first having received a written or
oral prescription for the drug from an authorized pre-
scriber, dispenses any drug for which a prescription is
required;

(7) Unless an authorized prescriber authorizes
the refill in the original prescription or by oral order,
refills a prescription for any drug for which a prescrip-
tion is required;

(8) Violates any provision of the Health Occu-
pations Article § 12-603 of Annotated Code of Maryland,
which concerns the home hemodialysis distribution

THE MARYLAND PHARMACIST

program;

(9) Is professionally incompetent;

(10) Is convicted of a crime involving moral tur-
pitude; or

(11) Is convicted of a violation of this title or any
other pharmacy law of any state.

05 Imposition of Penalties on Pharmacy
Permit Holders.

A. A penalty of not less than $100 nor more than
$2,000 may be imposed by the Board on a pharmacy
permit holder found guilty of any of the following:

(1) Except for a hospital pharmacy, failing to
provide services to the general public or restricting or
limiting pharmacy services to any group of individuals; or

(2) Offering pharmaceutical services under any
term or condition that tends to interfere with or impair
the free and complete exercise of professional phar-
maceutical judgment or skill.

B. A penalty of not less than $200 nor more than
$3,500 may be imposed by the Board on a pharmacy
permit holder found guilty of any of the following:

(1) Failing to locate or equip a pharmacy so that
it may be operated without endangering the public
health or safety;

(2) Failing to provide complete pharmaceutical
service by preparing and dispensing all prescriptions
that reasonably may be expected of a pharmacist; or

(3) Making any agreement that denies a patient a
free choice of pharmacists.

C. A penalty of not less than $500 nor more than
$5,000 may be imposed by the Board on a pharmacy
permit holder found guilty of any of the following:

(1) Conducting a pharmacy so as to endanger the
public health or safety;

(2) Failing to have a pharmacy under the per-
sonal and immediate supervision of a licensed pharma-
cist;

(3) Failing to operate a pharmacy in compliance
with the law and the rules and regulations of the Board; or

(4) Otherwise not conducting a pharmacy in ac-
cordance with the law;

D. The penalties as specified in Regulation .04
above may be imposed on pharmacy permit holders
found guilty by the Board of participating in any of the
activities that are grounds for Board action against a
licensed pharmacist under the Health Occupations Arti-
cle §12-311, Annotated Code of Maryland.

.06 Factors to be Considered in the Assessment
of Penalties.

In those cases in which the Board determines that
the imposition of a penalty is appropriate, the Board
shall take into consideration the following factors, with-
out limitations, in determining the amount of the pen-
alty:

A. The extent to which the pharmacist or pharmacy

NOVEMBER, 1982

permit holder derived any financial benefit from the un-
professional or improper conduct;

B. The willfullness of the unprofessional or im-
proper conduct;

C. The extent of actual or potential public harm
caused by the unprofessional or improper conduct; or

D. The cost of investigating and prosecuting the
case against the pharmacist or pharmacy permit holder.

.07 Payment of Penalties.

A. Any penalty imposed under these regulations
shall be due and payable to the Board as of the date the
Board’s order is issued unless the Board’s order
specifies otherwise.

B. Filing an appeal under the Administrative Pro-
cedure Act, Article 41, §255 et seq., Annotated Code of
Maryland shall not stay payment of any penalty im-
posed by the Board pursuant to these regulations.

C. If a pharmacist or pharmacy permit holder fails
to pay, in whole or in part, any penalty imposed by the
Board pursuant to these regulations, the Board may not
restore, reinstate, or renew a license or pharmacy per-
mit until the penalty has been paid in full.

D. In its discretion, the Board may refer all cases of
delinquent payment to the Central Collection Unit of
the Department of Budget and Fiscal Planning to insti-
tute and maintain proceedings to ensure prompt pay-
ment.

E. All monies collected by the Board pursuant to
these regulations shall be paid into the General Fund of
the States.

PD.

ACTUAL SIZE

Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the ‘‘P.D.” designa-
tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white
background, and cost $1.50 each.
To order, send check or money order for emblems @ $1.50
each to:
Maryland Pharmaceutical Assn.
650 W. Lombard St.
Baltimore, Md. 21201

Il

Camphor

By Lisa L. Booze, Pharmacist
Reprinted from Toxalert

Camphor is an ingredient in liniments, cold sore
preparations and other products designed to be applied
externally. It is still used rarely in mothballs. Accidental
poisonings occur in children and frequently in adults
who mistake camphorated oil for castor oil or cod liver
oil. Camphor is rapidly absorbed through the skin, mu-
cous membranes, and after ingestion. It acts primarily
as a central nervous system stimulant with symptoms
seen within 5-90 minutes. After ingestion, a burning
sensation develops in the mouth and esophagus with
nausea and vomiting also commonly seen. Stimulation
can range from mild excitation to grand mal seizures.
The National Clearinghouse for Poison Control Centers
reports a 20% incidence of convulsions in patients with
camphor intoxication. The onset of seizures may be
sudden and without warning. Postconvulsive depres-
sion generally occurs and may lead to coma. Death can
be a result of seizures or respiratory failure.

In children, 1 gram of camphor may be fatal and
symptoms can be seen with less. Many products contain
10% or 20% camphor, therefore as little as 1 or 2 tea-
spoonsful can be considered a potentially lethal dose. A
toxic amount of camphor in adults is 2 grams although
20 grams has been survived. There has been one case of
neonatal death 30 minutes after delivery and 36 hours
after maternal ingestion of camphorated oil instead of
castor oil.

Treatment consists of preventing the absorption of
the camphor and providing symptomatic and supportive
care. Poisindex®, a major toxicology reference source,
recommends lavage because of the rapid onset of
symptoms. The Maryland Poison Center suggests syrup
of ipecac in the asymptomatic patient and lavage if any
CNS symptoms are present. Activated charcoal and a
saline cathartic should follow. Oil based cathartics, al-
cohols, and fats (milk) are contraindicated because they
promote gastrointestinal absorption of camphor.
Diazepam may be needed to control seizures. Both lipid
hemodialysis and resin hemoperfusion have been effec-
tive in removing camphor from the blood of severely
poisoned patients. Patients should be observed by a
physician for a minimum of three to four hours.

Currently, there is a campaign underway led by
Carmine Varano, a New Jersey pharmacist, to remove
camphorated oil from the market. The Food and Drug
Administration and the Committee on Drugs of the
American Academy of Pediatrics have also spoken out
on the hazards and lack of benefits associated with
camphor. The FDA is now in the final phase of banning
this product.

12

APhA Publishes Seventh
Edition of Handbook of
Nonprescription Drugs

The seventh edition of the highly respected Hand-
book of Nonprescription Drugs is off the presses and
proving to be a best seller for its publisher, the Ameri-
can Pharmaceutical Association (APhA). ‘‘Initial sales
of this important text have been especially gratifying,”
said APhA president William S. Apple, Ph.D.

Three years in the making, the new edition of the
Handbook has been greatly expanded over its earlier
editions. Its more than 700 pages include 34 chapters, 32
of which are devoted to specific groups of drug products
and the disease states for which they would be used as
treatment. Each of these 32 chapters either is entirely
new or has been thoroughly revised from previous edi-
tions, and each is accompanied by tables listing all
major nonprescription drug products within that spe-
cific group. The individual listing include brand names,
manufacturers’ names, and active and (in many cases)
inactive ingredients. The product information was sub-
mitted by the manufacturers earlier in 1982.

Also new in this edition are a chapter discussing the
Food and Drug Administration’s continuing review of
nonprescription drug products, written by the director
of that review, William E. Gilbertson, and a chapter on
patient assessment and consultation. In addition, the
new edition includes a series of color plates which illus-
trate common dermatologic and dental/oral disease
states which are described in the Handbook.

The Handbook of Nonprescription Drugs is avail-
able for $45.00 ($30.00 for APhA members) from the
Order Desk, American Pharmaceutical Association,
2215 Constitution Ave., NW, Washington, DC 20037.
Orders totaling less than $200.00 and all foreign orders
must be prepaid in U.S. funds; foreign orders must also
include $9.00 per copy to cover shipping and handling.
To obtain APhA member rate, members must attach a
mailing label from an APhA periodical to their order.

ANTIGUA

January 23-30, 1983

wet

;
nip ‘Ap .
= A
o >
rao
'

THE MARYLAND PHARMACIST

The Handbook of
Nonprescription Drugs
Bigger and Better Than Ever!

The American Pharmaceutical Association's new
edition of the Handbook of Nonprescription Drugs is
now available for shipment. The opinion is unanimous
among all those who have examined the press proofs
and have seen the striking new design: “This is the
best edition of the Handbook ever to be published!’

For 15 years, pharmacists, physicians, and other
health care professionals have been turning to APhA’s
Handbook of Nonprescription Drugs for valuable,
practical health care information. No wonder it has
earned a reputation as the most comprehensive and
authoritative resource in its field—a reference you'll
want to keep within arm’s reach.

The new, seventh edition of the Handbook is the
result of three years of research, editing, and
review—involving some of the most prominent people
in their respective fields.

Look what’s in it for you

e Thirty-four information-packed chapters, including
new chapters on the FDA and OTC drugs and patient
assessment and consultation

e Dozens of full-color photographs in a special
8-page section showing common dermatological and
dental/oral conditions, plus numerous anatomical
illustrations and other artwork throughout the book

e More than 100 pages of easy-to-read product
tables featuring concise and updated ingredient infor-
mation on nonprescription drugs

e Comprehensive indexing, including trade names,
generic names, disease conditions, and symptoms.

Order Desk, Dept. St.

American Pharmaceutical Association
2215 Constitution Ave., NW
Washington, DC 20037
(202)628-4410

Please send me copies at$
Name

Street address

City

State

Use the convenient form below to order your copy.
Orders are being filled now—so don't wait.

Handbook of Nonprescription Drugs, 7th Edition
722 pages, hard cover plus dust jacket, 1982,
22 x 27 cm; $45 ($30 for APhA members)

7th Edition of the Handbook of Nonprescription Drugs
$45.00 ($30.00 for APhA members)
(Foreign orders add $9.00 for postage and handling)

ZAR

All orders totalling less than $200 and all foreign orders must be prepaid in U.S. funds.

To receive the mermnber rate, attach your mailing label from an APhA publication.

820901

( WE DISPENSE
LILLY INSULINS

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Product dependability

For 60 years, “Lilly” has been nearly synonymous with “insulin” to
most people. Iletin® I (beef- pork insulin) and Iletin® II (purified
pork or purified beef insulin), the trade names for Lilly insulins, are
known for their consistent quality. Lilly research constantly strives to
develop new products, such as biosynthetic human insulin, and
improved delivery systems.

Distribution system

[he unmatched Lilly retail distribution system insures that Iletin
products are available all over the United States. Such availability
otters both convenience and reassurance to your customers.

Ancillary services for you and your customers

Lilly prov ides medical service items to physicians, patients, and phar-

macists who use Iletin. We also offer monographs on diabetes, a full

range of diabetic diets, and patient information on diabetes. Out- 200664
dated Iletin can be exchanged promptly for other Lilly products.

Please contact your Lilly representative for assistance Lilly

with these services.

Eli Lilly and Company
For information on insulin delivery systems, contact Cardiac Pacemakers, Inc., at 1-(800)-328-9588 Indianapolis, Indiana 46285

Bus eats magaynes, faprtbaek Cocks
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agatn re NACE pe ‘i. “ow 5

That's the prescription you can fill again and again for your customers if you have a fully
stocked magazine department.

Reading is a tonic for everyone. SELLING the reading material is our specialty. And it
should be yours because turnover is the name of your game and nothing you sell turns over
faster or more profitably than periodicals.

If you're not now offering periodicals to your customers, you should be. Just ask us how
profitable it can be.

And if you do have a magazine department, chances are your Operation has outgrown it
and it should be expanded.

Get on the bandwagon. Call Phil Appel today at:

The Maryland News Distributing Co.
(301) 233-4545

NOVEMBER, 1982 15

FYI

Major manufacturers of
computer systems

pharmacy

Company

Anacomp Inc.
2779 152 St. NE
Redmond, Wash.
98052

Apothetech Inc.
23800 Hawthorne
Blvd.

Torrance, Calif. 90505

AutoScript Inc.
11 Mountain Ave.
Bloomfield, Conn.

Computer Inc.
240 N. Rock Road
Wichita, Kan. 67206

The Condor Corp.
P.O. Box 2311
Birmingham, Ala.
35201

DBIS

1 Mayfair Road
Eastchester, N.Y.
10707

Delphi Associates Inc.
5824 Forbes Ave.
Pittsburgh, Pa.

5110 System Inc.
400 Moody Bldg.
Tremont Square
Claremont, N.H.

03743

G/H Systems
il? |S. ew She
Joplin, Mo. 64801

General Computer
Corp.

P.O. Box 304
Twinsburg, Ohio 44087

IBM

900 King St.
Portchester, N.Y.
10573

J. M. Smith Corp.
Data-Processing Div.
P.O. Box 1779
Spartanburg, S.C.
29304

National Data Corp.
1 NDC Plaza
Corporate Square
Atlanta, Ga. 30329

Norand Corp.

550 Second St.
P.O. Box 666
Cedar Rapids, lowa
52401

Pacific Pharmacy
Computers Inc.

5205 Kearny Villa Way
#110

San Diego, Calif.
92123

TBL Inc.
720 S. Kimball
Southlake, Tex. 76062

3 P.M. Inc.

30881 Schoolcraft
Livonia, Miss. 48150
Pharmacom

2301 Ave. J

Arlington, Tex. 76011

Polaris
Microcomputers Inc.
8200 Haskell

Van Nuys, Calif. 91406

Programs + Analysis
Inc.

Professional Health
Systems Div.

21 Ray Ave.
Burlington, Mass.

The United States Pharmacopeia keeps you up-to-date
with the 1983 USP Dispensing Information (USP Dl)—a
newly expanded and updated edition, available for the first
time as a two-volume set.

UPDATE THYSELF.

Volume | is the pharmacist’s guide to over 4,500 drug
dosage forms and brands. Volume II is a corresponding lay
language guide for patients, designed for use as a patient ed-

ucation tool. To order your copies, just mail in the coupon below.

RE nnn Num tum Wit 07 1 1 aret-crciaee eae RaneRRenaneeaanemeae ahaeteer atria aaa

Quantity

Total Cost $

Expiration Date:

Please send me the following:

1983 USP DI, each complete two-volume set, $37.95. *
______ Additional copies of USP D/ Volume ||, Advice for the Patient, at $17.95* each.

About Your Medicines Consumer Display Kit (12 lay language paperback books packaged in counter-top display

box), $36.00. (Suggested retail price $4.95.)
_____—«1980 USP XX - NFXV, $75.00* *: or $100.00* * with annual supplements.
Free Patient Education Program Promotion Kit.

MAIL TO: Maryland Pharmaceutical Association
650 W. Lombard Street
Baltimore, Maryland 21201

Enclosed is my check or money order for $___

VISA CO MASTERCARD Account Number:L I LILI MI JODO ODDO OOo

Signature:

SEND TO:

CITY:_

<a a A PA ee

ADDRESS:

payable to USP, or charge my order to:

STATE:

ZIP:

“Maryland residents add 5% sales tax. **Pennsylvania residents add 6% sales tax.

1983 USP Dis will be shipped in July 1982.

PHARMACY

NUMBER 6

A continuing education service from

NEWSLINE ~

EDITORS’
COMMENT

“It’s time to join the PAC, man!”

“Beat the heat, join PAC!”

“Political Issues? Political Action!”
What’s happening in pharmacy—are

we all becoming politicians? More and

more, pharmacists around the country
seem to be adopting the National Asso-

ciation of Retail Druggists’ slogan of a

few years ago: “Get Into Politics, or Get

Out of Pharmacy!” For example:

@ More than half of the state pharmacy
associations have political action
committees that collect contributions
for candidates for local, state, and
national office.

e Pharmacists have been elected to or
are running for seats in the state
legislatures of New Jersey, Illinois,
Oklahoma, and Michigan, among others.

@ Members and staff of the Kentucky
Pharmacists Association recently
lobbied successfully for the passage
of six pieces of favorable state legis-
lation.

e Many state pharmacy associations hold
annual “legislative days” to acquaint
pharmacists with their state legislators.

e More and more pharmacists attend
the NARD Legislative Conference or
other meetings in Washington, DC, to
become better acquainted with their
congressional representatives and
national issues.

What’s happening is that pharmacists,
like many other Americans, have dis-
covered that the political system is “where
it’s at.” A favorable economic or profes-
sional climate does not develop by itself.
The solutions to some of pharmacy’s
problems can be accomplished only by
Cultivating respect and influence in the
state and national legislative arenas, and
by participating in the hard work neces-
sary to accomplish our objectives.

Do pharmacists want more professional
responsibility? Favorable tax laws?
Equitable third-party reimbursement?
Protection against pharmacy crime?
Positive results are by no means guaran-
teed in politics, but there’s no other
game in town. Gaining legislative knowl-
edge and influence are important but, as
usual, “there’s no such thing as a free
lunch!” The costs of legislative success
are threefold: information, time and
money.

WYETH LABORATORIES

Pharmacists first must be willing to
obtain information—to learn about the
issues important to pharmacy—and to
help develop solutions to problems con-
fronting the profession. We also must be
willing to donate time to help resolve
legislative issues. That means showing
up at the legislature when needed, testi-
fying on legislation, doing volunteer work
for good candidates, visiting with legis-
lators, and whatever else may be neces-
sary. And of course, we must “put our
money where our mouth is.” Contribu-
tions to state and national political action
committees, and to other legislative ac-
tivities, are mandatory. If pharmacists
aren't willing to spend money to develop
active legislative programs, other interest
groups are.

When was the last time you visited
your state legislature? Or wrote a letter
to your congressman? Or contributed to
a legislative candidate ora political action
committee? Do you vote in every election?
The time is right, pharmacists—“Get into
Politics, or Get out of Pharmacy!” The
success of our nation’s democratic
government depends on our participa-
tion.— RPM

ABOUT
ORGANIZATIONS

On August 26, 1932, representatives of
the American Pharmaceutical Associa-
tion, the American Association of Col-
leges of Pharmacy, and the National
Association of Boards of Pharmacy, met
in Toronto, Canada, to finalize the for-
mation of an organization to ensure
quality education for America’s pharma-
cists. The resulting American Council on
Pharmaceutical Education (ACPE) now
is celebrating its 50th anniversary.
Although few practicing pharmacists
interact directly with ACPE, its activities—
accrediting professional degree programs
and approving providers of continuing
pharmaceutical education—benefit the
entire profession. Colleges of pharmacy
must meet the strict accreditation stan-
dards of ACPE every six years, demon-
strating educational quality in lengthy
self-study reports and during two-day,
on-site visits by ACPE staff and members.
The colleges realize the importance of
maintaining ACPE accreditation: pro-
grams at 72 of the nation’s 73 colleges of
pharmacy now are accredited, and the

last currently is a candidate for accredi-
tation. ACPE’s standards of accreditation
are revised periodically to reflect im-
provements in pharmacy practice and
education, and the latest revision should
be completed next year. ACPE also ap-
proves providers of continuing pharma-
ceutical education. The more than 175
providers must meet requirements in the
areas of educational quality, publicity,
record-keeping, and evaluation. Many
states that require continuing pharma-
ceutical education universally accept
programs provided by ACPE-approved
organizations.

ACPE is governed by a ten-member
board of directors. Each of the three
founding organizations appoints three
members, and the tenth is appointed by
the American Council on Education. The
current president of the ACPE Board is
Pharmacist Grover C. Bowles, Jr., of
Baptist Memorial Hospital, Memphis,
Tennessee. ACPE’s staff, which includes
Executive Director Daniel A. Nona, R.Ph.,
Ph.D., and Assistant Executive Director
W. Robert Kenney, Ed.D., also receives
direction from an advisory committee on
continuing education and a public ad-
visory panel. It is likely that ACPE’s high
standards of pharmacy education will be
maintained in the future. Besides an-
swering to its prestigious Board of Direc-
tors, ACPE must meet the guidelines of
the US Department of Education and
the American Council on Postsecondary
Education. Congratulations to ACPE on
a very successful 50 years!

REGULATION
REVIEW

The US Court of Appeals for the Second
Circuit has struck down a class action
suit brought by 700 Connecticut phar-
macies, ruling that Blue Cross and Blue
Shield of Connecticut was the actual
purchaser of prescribed drugs under its
plan and that the establishment of a
maximum price to pay pharmacists was
not price-fixing. The pharmacists had
argued that agreements between the
third party and the pharmacies consti-
tuted illegal resale price maintenance or
horizontal price-fixing. This is one of a
growing number of cases in which the
third party has been deemed the actual
purchaser of prescription drugs. Such
decisions essentially may negate the

NUMBER 6

PHARMACY
NEWSLINE

Editors:
David A. Banta, M.A.
Robert P. Marshall, Pharm. D.

Publisher:
Martin J. Zittel

Executive Editor:
Linda Harper

Assistant Managing Editor:
Sheri Steinberg

Production Manager:
Susan Smith

Developed by Continuing Professional Education,
625 North Michigan Avenue, Chicago, Illinois 60611.

Published by Professional Communications Associ-
ates, 625 North Michigan Avenue, Chicago, Illinois
60611. Circulated to selected practicing pharmacists.
©1982, Professional Communications Associates,
Division of Sieber & McIntyre, Inc. All rights reserved.
None of the content of this publication may be
reproduced in any form without the written permis-
sion of the publisher.

This statement applies to all articles appearing in
this publication: The editors have complete inde-
pendence in selection of such articles. No article has
been predisclosed to the advertiser, and the adver-
tiser has exerted no influence on the information
appearing in any article. The opinions expressed in
the articles are those of the authors, and are not to
be construed as the opinions or recommendations
of the advertiser or publisher.

Editorial correspondence should be directed to the
attention of the Executive Editor, Continuing Pro-
fessional Education, Suite 800, 625 N. Michigan
Ave., Chicago, IL 60611.

intended effect of the various “third-
party” laws being pursued by many state
pharmaceutical associations.

The lowa Medicaid program has de-
veloped a program to provide an incen-
tive to pharmacists to perform drug
product selection when the use of generic
drugs saves the program money. Effective
October 1, 1982, a $0.50 reimbursement
fee will be added to the $3.53 dispensing
fee when generic substitution results ina
savings of at least $1.50 to the Medicaid
program.

As of July 1, 1982, 32 states had
Medicaid outpatient dispensing fees of
at least $3.00. Seven of these states had
variable fees, with the highest limit of the
scale above $3.00.

The states of Florida and Georgia have
placed methaqualone on Schedule |,
making it illegal to dispense the drug
through normal delivery channels. Similar
legislation has been reported in South
Carolina, Louisiana, Delaware, and
Alabama.

The Arizona Medicaid experiment is
nearing the implementation stage. Ari-
zona drew national notice when it adopted
a Medicaid program that for the first time
subjects all health care components of
the program, including prescription
drugs, to the bidding process. Requests
for proposals are being sent out and the
program could be operational by October
1st.

Responding to a request from the
Missouri Pharmaceutical Association, the
state’s Attorney General ruled that a
dispensing physician must perform all of
the functions relating to the dispensing
of medications personally, except the
preparation and affixing of the label to
the medication container. The Associa-
tion had been concerned for some time
about the dispensing of medications by
unauthorized personnel and the use of
improperly labeled and sealed containers.

The State of Missouri recently instituted
a Medicaid client-copayment requirement
that will increase pharmacists’ fees to $3

on prescription medications costing
$10.99 or less, and to $3.50 on medica-
tions costing more than $11.

ASSOCIATION
NEWS

Massachusetts Governor Edward King
was the guest of honor at a reception
held at the home of Paul Dumouchel,
Past President of NARD and the Massa-
chusetts Pharmaceutical Association.
The reception was held by the Dumouchels
and many other Massachusetts pharma-
cists to demonstrate their gratitude to
the Governor for his assistance to the
profession.

The Virginia Pharmaceutical Associa-
tion has adopted a resolution that con-
tinues and expands the efforts of an
employee-employer task force established
in 1981. The task force was developed to
formulate VPhA programs and services
for improving communications between
employee pharmacists and their em-
ployers, and to develop ways of making
pharmacy practice more rewarding for
both groups.

The Massachusetts State Pharmaceuti-
cal Association recently introduced a
public education program, “The Pass-
book to Good Health Care,” via “The
Brown Bag Project.” In this program,
senior citizens are asked to put all of
their medications in a brown bag and
take them to a central location. Pharma-
cists at the site check the contents of the
bag, answer questions, and make recom-
mendations regarding compliance, and

assist in the discarding of old, unfinished, -

or outdated medications. Patients then
are given the “Passbook,” which contains
a page for information on every drug the
patient takes, plus other pertinent infor-
mation about the patient for emergency
use.

The Missouri Pharmaceutical Associ-
ation continues its unique public service
announcements using the puppet “Fred
Pharmacist.” Three television announce-
ments dealing with safety closures,

cleaning out the medicine cabinet, and
patient compliance have been developed
in addition to last year’s message on the
hazards of mixing medicines and alcohol.
The Association also plans to make the
television spots available to other state
pharmaceutical associations.

Pharmacists in Colorado recently

.formed the Denver Area Pharmacy Pro-

viders (DAPP) group to compete for a
contract with the Comprecare HMO to
service approximately 24,000 patients.
DAPP has a membership of 65 inde-
pendent community pharmacies.

The Pennsylvania Pharmaceutical As-
sociation has commissioned a painting
by artist David Armstrong entitled “The
Apothecary Shop.” Prints of the painting
are being sold by the Association at $100
each and should become collectors’
items.

A “Long Range Plan” recently was
adopted by the South Carolina Pharma-
ceutical Association “to provide quality
services to members in the areas of
professional development, unity of pur-
pose, and economic security, thus pro-
moting quality pharmaceutical services
to the public and enhancing the growth
of the Association and the profession of
pharmacy.”

Pharmacists in New Hampshire banded
together to defeat the plan of an HMO—
the Matthew Thornton Health Plan—to
build two inhouse pharmacies that would
compete with 13 local community phar-
macies. The pharmacists reminded state
and federal legislators that their own tax
dollars would be used to fund construc-
tion of the HMO pharmacies. The HMO
agreed to rescind its plan and drawupa
cooperative agreement with area phar-
macies.

The Minnesota State Pharmaceutical
Association recently published an open
letter to candidates for the Minnesota
legislature. The Association outlined the
growth of third-party programs and diffi-
culties the Minnesota pharmacists have
had in the area of reimbursement. The
letter also asked candidates to respond

to the letter so that comments could be
published in the Association journal for
the members’ information.

Members of the Michigan Pharmacists
Association participated in the “Senior
Power Day” exhibition, which attracted
over 6,000 senior citizens. Members
manned an MPhA exhibit booth, distri-
buting information on drugs and the
elderly and informing the public about
the Association’s Speaker’s Bureau.

Working with law enforcement officers,
security experts, former addicts and
pharmacy robbers, and others, pharma-
cists in the Orlando area formed the
Central Florida Theft Prevention Com-
mittee. The cooperative effort reportedly
has resulted in a 90% decrease in phar-
macy-related crimes in a nine-month
period.

The National Pharmaceutical Council,
recognizing that action on many health
care issues will be decided on the state
level in the future, will form a series of
state-based health field/consumer group
coalitions. The first group, the Rhode
Island Medication Education Council,
includes pharmacy, physician, industry,
and consumer organizations. Other state
coalitions will be formed and will receive
support from NPC to provide information
on medication and the health care system
to legislators and the public.

The Texas Pharmaceutical Associa-
tion was awarded First Prize for Inter-
association Relations in a contest spon-
sored by the American Society of Asso-
ciation Executives Management Show
Care for 1982. The award recognizes the
Association’s six-year effort to revise the
pharmacy practices act in Texas through
a coalition with other interest groups.

The National Association of Boards of
Pharmacy reports that there are approxi-
mately 159,958 pharmacists in the United
States. Of that number, 74.11% are in-
volved in community pharmacy, 18.52%
practice in hospital pharmacies, 1.36%
are involved in manufacturing or whole-
saling, 3.04% teach or are ingovernment,
and 3.02% practice in other capacities.
The report also found that 20.53% (ap-
proximately 32,207) of all active phar-
macists are women.

The New Jersey Academy of Consul-
tant Pharmacists has become an Official
component of the New Jersey Pharma-
ceutical Association.

The Michigan Pharmacists Association
released a study conducted by Wayne
State University showing that the average
Michigan pharmacy loses $10,198 an-
nually because of inadequate reimburse-
ment fees from third parties. The Associ-
ation pointed out that pharmacists were
forced to shift the expense in lost profit

SAYING

from over half of the prescriptions they
dispensed from third-party reimburse-
ment to the private sector.

The Washington State Pharmaceutical
Association has redesigned its popular
auxiliary drug warning labels. Thirty of
the labels will use international symbols
that should be better understood by the
public.

The Minnesota State Pharmaceutical
Association is offering its members a
series of public service advertisements
for use in newspapers. The Association
will develop 26 newspaper ads so in-
terested member pharmacies can sponsor
a different ad in local newspapers every
other week for a year. The ads can be
customized to include the sponsoring
pharmacist’s picture and pharmacy name.
The Association is encouraged by initial
response to the ad, with more than 100
pharmacists requesting copies.

Each year, members of the lowa Phar-
macists Association help man a phar-
macy museum at the lowa State Fair.
Volunteers serve in four-hour shifts and
receive complimentary tickets to the Fair.

WHAT THE Y’RE

On the Future of Pharmacy: “Exactly
what do we want the pharmacy profession
to become? Progress and change are
necessary in any profession, but we
need to take a closer look at the direction
we are taking. | often wonder if the
independent retail pharmacy isa thing of
the past. Has pharmacy progressed so
far that people will not be able to go to
their neighborhood pharmacy? Will it all
become impersonalized, commercialized,
and computerized?

Let’s get our act together. Are we
willing to take a stand on issues and be
held accountable for the future of our
own profession? No longer can we stand
in the background and let others make
our decisions for us. Each and every one
of us must be willing to make a commit-
ment to our profession. We are respon-
sible for our own actions—or lack of
action.

‘What can | do?’ you ask, ‘lam only one
person.’ As one person, you can become
a member of your local, state, and national
pharmacy organizations, attend meetings,
get to know your legislators, learn the
issues, voice your opinion, ask questions,
use your telephone and typewriter, and
involve a fellow pharmacist. All of these
things, and more, will help to determine
the future of pharmacy, and youcan bea
part of it!’ Pharmacist Marian Ricardo,
Southeast Alternate Regional Director,
Pennsylvania Pharmaceutical Associa-
tion, in The Pennsylvania Pharmacist,
May 1982.

On Cooperation Between Pharmacy
Colleges and Professional Associations:
“Our professional associations need to
be able to interact well with pharmacy’s
other primary resource—our colleges.
Pharmaceutical association officers,
executives, and members must work
with faculty and students to bring out a
fuller awareness of the problems, in-
cluding those of an economic type, which
plague pharmacy (as well as other health
professions) today, because most faculty
and students at many of our colleges
tend to be isolated from these problems.
In bringing an awareness of issues of
current practitioner concern to faculty
and students, pharmacy associations
should strive to inculcate positive atti-
tudes toward pharmacy practice. Prob-
lems need to be presented, but ap-
proaches to solving the problems facing
the profession must also be stressed so
that negative attitudes toward pharmacy
practice will be avoided. Practitioner
organizations should serve in an advisory
way in curricular design and curricular
updating at our colleges, but this must
be done in a knowledgeable way, dis-
playing an understanding of the varied
and competing concerns that exist in
total curricular planning, and the special
needs or specialty areas of emphasis
that may exist in any individual college.”
Dean John L. Colaizzi, Rutgers College
of Pharmacy, in “Challenges in Returning
Pharmacy Practice to the Control of
Pharmacists,” The Pennsylvania Phar-
macist, May 1982.

KUDOS —

Congratulations to former South Carolina
Pharmaceutical Association Executive
Director J. Coleman Daniel, who recently
entered the full-time ministry, and who
was recently married.

Pat Powers, managing editor of the
Florida Pharmacy Journal, and wife of
Florida Pharmacy Association Executive
Director Jim Powers, recently was ap-
pointed by Florida Governor Bob Graham
to serve as a lay member of the Florida
Board of Psychological Examiners.
Congratulations!

Best wishes to Michigan pharmacists
David Bennett and Howard Dell, who are
candidates for seats in the Michigan
House of Representatives.

CALENDAR
OF EVENTS

October 10-14, 1982

NARD Annual Convention, Boston, MA
December 5-9, 1982

ASHP Midyear Clinical Meeting, Los
Angeles, CA

April 9-15, 1983

APhA Annual Meeting, New Orleans, LA

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-

A Brief History of USPHS
Pharmacy in Maryland

George F. Archambault

continued from the June Issue

Part XIV

There follows, to complete the article, (1) a report
on the National Clearing House for Poison Control
Centers and the Pharmacist’s Role and (2) a correction
to the Division of Hospitals Deputy Chief Pharmacist
chronological history as appeared on page 20 of Part 1 of
the article. The corrected table should be referred to
from 1973 in lieu of the original—I am indebted to
Pharmacist Director Kent Johnson, currently Deputy
Director, Division of Drug Monographs, FDA, USPHS
for this information. Johnson was chief pharmacist at
the Baltimore PHS Hospital from 1970 to 1978. The
Baltimore PHS Hospital along with the other PHS hos-
pitals was phased out in early 1982 under the Reagan’s
economic program. It continues operation however as a
non-profit local institution (Wyman Park Health Sys-
tems Inc.) and also cares for uniformed service person-
nel among others on a reimbursement basis from the
U.S. government. Bonnie Pitt, a former commissioned
pharmacist officer is currently its chief pharmacist. Pitt
was the chief infectious control officer of the hospital,
attached to the pharmacy department in the later years
of the institution as a PHS facility. A corrected Deputy
Chief Pharmacist chronological chart for the years 1973
to 1981 as supplied by Johnson follows:

DEPUTY CHIEF PHARMACIST

Walker, Thomas 1973-1974

Open 1974-1975
Walker, Thomas 1975-1977
Tonelli, Robert 1977-1978
Buehler, Gary 1978 —1979
West, Robert 1979-1981

* As reported to the author by Pharmacist Director (Retired)
Henry L. Verhulst of Bethesda, Maryland—1982.

NOVEMBER, 1982

National Clearing House for Poison
Control Centers—USPHS*

The poison control center concept and the first cen-
ter were developed with the assistance of the previous
Academy of Pediatrics in the early 1950’s. The National
Clearing House for Poison Control Center was estab-
lished in the U.S. Public Health Service in 1957 by Sur-
geon General Leroy Burney to collect information on
formulation and toxicity of all drugs and household
products, develop treatment for ingestions, aid in the
establishment of new state centers and develop educa-
tional programs to reduce childhood poisoning.

Dr. Howard Conn, Pediatrician was named Director
of the new program and Pharmacist Director Henry L.
Verhulst of Bethesda, Maryland, was named Assistant
Director. In 1960, Dr. Conn left the Public Health Ser-
vice and Pharmacist Verhulst was named Director.
During the 60’s and 70’s Corps Pharmacists staffed the
program with the responsibility of reviewing industry’s
material and supplying over 500 centers with toxicity
and treatment information, so poisoned children could
be treated efficiently.

In 1982 most activities of the program were reduced
by FDA Commissioner Hayes “‘because of its success
in achieving its goals, future activities will be concen-
trated on collecting information about poisonings,
analysing that information and communicating any sig-
nificant problems that are uncovered.”

The deaths to children under 6 years of age from
poisoning from liquid and solids dropped from about 450
in 1960 to about 110 in the late 1970’s. Hopefully we will
not see a reversal of this trend.

Conclusion

A reading of this short history of PHS pharmacy and
pharmacists in and of Maryland is by its very nature an
incomplete one. Apologies are made for names inad-
vertently omitted and duty stations not remembered.
Readers are invited to add to this report by letters to the
editor of this Journal for publication in later issues to
help complete “‘the record.’’

17

When
was the
last time
your
Insurance
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gave you

a check...
that you
didn’t ask for?

MAYER and
STEINBERG

Insurance Agents & Brokers

600 Reisterstown Road
Pikesville. Maryland 21208
484-7000

MAYER and STEINBERG INSURANCE
AGENCY GIVES A DIVIDEND CHECK TO
RONALD A. LUBMAN EVERY YEAR! Usually
for more than 20% of his premium.

RONNY ts one of the many Maryland phar-
macists participating in the Mayer and
Steinberg/MPhA Workmen's Compensation
Program—underwritten by American
Druggists’ Insurance Company.

For more information about RECEIVING
YOUR SHARE OF ANNUAL DIVIDENDS...
call or write: -

Your American Druggists' Insurance Co. Representative

armco AMERICAN
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information about the Mayer and Steinberg/MPhA Workmen's
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ee
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1980, —

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c) 1981 Warner-Lambert Company PD-220-JA-0173-P-4(1-81)

BERTERS

Dear Mr. Banta:

I very much appreciate the old prescription and
apothecary jar which you so thoughtfully presented to
me on September 28, 1982. I was pleased to proclaim
‘‘Maryland Pharmaceutical Association Founding
Day” and am glad that you were able to join me for
the proclamation ceremony.

You have my best wishes.

Sincerely,
Harry Hughes
Governor

Dear David,

Colorado Pharmacal Assn. would like to extend
heartiest congratulations to you and your fine organiza-
tion on your one-hundredth anniversary October 1882-
1982.

Pharmacy has come a long way since then and many
of these changes must be attributed to the Maryland
association and the thousands who have labored zeal-
ously in the pursuit of better health care for all.

As you start a new century of benefit to mankind
through pharmaceutical education may you continue to
grow and prosper as you have in the past.

Best wishes to all.

Sincere regards,
Arthur C. Hassan, Jr.
Executive Director, CPhA

Gentlemen:

Does anyone remember a Medicated Ointment called
‘““ROSE-VEL”’ which was made by H. Clarke and Sons,
Inc. in Riverdale, Maryland? They are now out of busi-
ness and several years ago, I obtained this ointment
from a firm on Roade Island Ave. N.E. I believe. Food
and Drug has no information on this product.

Can anyone help me to locate this Boric Acid base, of
Petrolatum and Paraffine Medicated Ointment?

Thank you,

Ernest Zsoldos

3513 Parkway Terr. Drive, #2
Suitland, Maryland 20746
Phone: 736 0165 or 735 2420

20

Dear Mr. Dave Banta:

I would like to take this opportunity on behalf of
Charles R. Buck, Jr., Sc.D., Secretary of Health and
Mental Hygiene, to thank the Association for having
provided the necessary funds to keep the Division of
Drug Control newsletter in circulation. Without your
cooperation, the Department would not have been in a
position, due to budgetary restraints, to continue to de-
velop and apprise appropriate professionals of such
meaningful data.

Please be advised that the Division has been ade-
quately funded for the 1983 fiscal year, therefore, will
be mailing the newsletter as in the past.

Again, we truly appreciate your assistance and look
forward to many years of cooperative efforts.

Sincerely yours,
Charles H. Tregoe, Chief
DIVISION OF DRUG CONTROL

Dear Mr. Banta:

Enclosed please find the Centers for Disease Con-
trol (CDC) Revised Recommendations on Retesting
with Tubersol (STU Tuberculin Antigen by Connaught).

To summarize their recommendations:

1) Retest with Tubersol those individuals on
Isoniazid (INH) preventive therapy based on
positive reactions to ‘‘Old Batch’’ Aplisol.

2) Retesting is not recommended

a. Close Contacts

. Abnormal Chest X-Rays

. Tuberculosis Cases

. Foreign Born

. Indurations Greater than 20 mm
f. Negative Skin Test.

Please disseminate this information to members of
your organization. Thank you for your assistance.

ay fel te) lop

Sincerely,

Stanley A. Morita, Chief,
Respiratory Disease Control Program
(301) 383-2816

THE MARYLAND PHARMACIST

Consumer Attitudes
about Pharmacists

A recent study exploring the reasons consumers
select a particular pharmacy reveals that the choice is
firmly based on personal as well as professional criteria.
In examining pharmacist-consumer views on key is-
sues, the independent study, commissioned by the
Schering Division of Schering-Plough Corporation,
reaffirms data collected four years ago.

‘Once again, a pharmacist’s advice and counsel on
health matters, fast prescription service and helpful,
courteous sales-people were among the factors cited
most often by consumers,’ according to G. F. Tom
Grimaldi, vice president—industry affairs, Schering Di-
vision. *‘The findings confirm the growing recognition
of the pharmacist as a health professional concerned
with the well-being of his customers,”’ he said.

The study, Schering Report IV, followed up on a
1978 Schering Report, which probed the significant dif-
ferences between pharmacist and consumer points of
view on a wide range of issues. Results were developed
from over 200 personal interviews with pharmacy own-
ers, managers and employees of both chain and inde-
pendent pharmacies in 20 metropolitan areas. Consum-
ers surveyed included a national sampling of 2,000 men
and women.

‘“‘Overall, there is ever-growing evidence of con-
sumer satisfaction with their pharmacists,’’ Grimaldi
noted. *‘In the earlier survey, 56 percent of consumers
reported that pharmacists filled their prescriptions
promptly. In the new study, that figure rose to 73 per-
cent, a significant improvement in an important aspect
of pharmacy.”

‘‘On the other hand,’’ he continued, ‘“‘some 22 per-
cent of consumers were annoyed because their phar-
macy took too long to fill prescriptions. Nevertheless,
nearly half of the consumers have no serious complaints
about their pharmacy.”’

On the question of the pharmacist as a professional,
with number one representing ‘‘health professional’
and number seven ‘‘skilled worker’’, the consumer’s
rating increased from 3.2 percent in 1978 to 2.9 percent
in the new study.

Of the 15 factors considered in a consumer’s selec-
tion of a pharmacy, pharmacists and consumers
strongly agree that the pharmacist would detect pre-
scription errors and tell the patient about the prescrip-
tion even when the patient doesn’t ask. They also agree
that the consumer’s confidence in the pharmacist’s rec-
ommendation of nonprescription medicines is an im-
portant factor.

But some differences in perceptions and expecta-
tions do exist. ‘Interestingly enough, three primary
areas of disagreement involve the pharmacist’s avail-
ability for consultation,’ Grimaldi pointed out. ** Phar-
macists rank these statements in first, second and third
place as reasons consumers patronize a particular
pharmacy: pharmacist is available to ask about medica-
tions; pharmacist is available to ask about health prob-
lems; and it’s easy to get the pharmacist to talk. Con-
sumers, however, listed these factors in seventh,
twelfth and eighth positions.”

The consumer’s top three reasons for selecting a
drugstore were: pharmacist fills prescriptions promptly;
complete confidence in my pharmacy; and it’s easy to
talk to my pharmacist. Pharmacists, on the other hand,
ranked these factors in fifth, seventh and eighth order.

Differences in perception also emerged on the issue
of helpful, courteous nonpharmacist salespeople. This
was the third most important factor in a consumer’s
choice of a pharmacy. Pharmacists placed this reason in
ninth place. ‘“‘This suggests that pharmacists train their
nonpharmacist salespeople to be more attentive to the
consumer's personal needs,”’ he said.

Another major finding surfaced when consumers
were asked to complete the statement: ‘‘the one thing I
like best about the pharmacy I usually go to is. ...”
Some 31 percent said they like the pharmacist best.
‘His professionalism was singled out by 15 percent of
the consumers in the 1978 study compared to 22 percent
in the new report,’’ Grimaldi noted. “‘Friendliness also
scored high in both studies.”

‘‘Consumers also like a convenient location, fair
prices and overall good service,’ he added.

Finishing the statement ‘“‘the thing that annoys me
most about the pharmacist I usually go to is ...”’,
nearly half of the consumers said nothing annoyed
them. The most frequent complaint was slow prescrip-
tion service, a crowded and cluttered store and having
to wait in line to pay for a purchase. Annoyance over
the perceived high price of drugs actually fell from nine
percent in 1978 to eight percent in 1982.

Summarizing the survey results, Grimaldi stressed
the importance of personal factors in pharmacist-
consumer relations. ‘‘While consumers are quite satis-
fied with their pharmacists, there is still room for gain-
ing greater consumer confidence, improving services
and increasing sales,’ he said. ‘“‘Pharmacists should
make themselves more available for consultation on
health matters, try to fill prescriptions promptly or at
least explain why the delay is necessary, and institute
training programs for salespeople and new pharmacists.
Taking these steps, pharmacists can better serve the
community while enhancing their professional status.”

A booklet summarizing the Schering study is avail-
able by writing: Pharmacy Affairs, Schering Division,
Kenilworth, New Jersey 07033.

eS a eS RR RR a IN I a eS ES ee Se Ee

NOVEMBER, 1982

21

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Faster In 60-Seconds
¢ Better — ¢ Item and
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¢ Complete
* Better | Pricing and
Pricing Product
Information Information

District Wholesale Drug Corp.

7721 Polk Street A\Z
Landover, MD 20785 Es @ Spectro Industries, Inc.
(301) 322-1100 sae ms

Divisionsof 3 = Jenkintown Plaza
Loewy Drug Co. 4 ¢> Jenkintown, PA. 19046
6801 Quad Avenue 2 Nw (215) 885-3676

Baltimore, MD 21237
(301) 485-8100

Consider:

Ask Yourself:

Then Consider:

Mail:

What Can
Your
Association
Do For

You

That You
Cannot Do
Alone?

Governmental Agencies

Third Party Insurance Programs
The Legislature

Consumer Groups

How can one person impact these groups?

More than 1000 Maryland Pharmacists have decided to make their impact by
working together in the Maryland Pharmaceutical Association.

And their effort is paying off. This past year we succeeded in raising the
Medicaid dispensing fee to $3.25 and repealing the price poster. A year long
Centennial Celebration has helped to draw the public’s attention to the
profession.

Pharmacists can do even more together. But the MPhA needs every Maryland
Pharmacist to strengthen the voice of Pharmacy. The MPhA needs you.

Send your membership dues for 1983 today. New members sending 1983 dues
now will receive membership for the rest of 1982 at no charge and can still
receive the Centennial “Doctor of Pharmacy” Certificate.

You alone can help yourself by working with others.

Maryland Pharmaceutical Association, 650 W. Lombard Street, Baltimore, Maryland 21204

Phone (304) 727-0746

NOVEMBER, 1982

lf You Are
PREGNANT

Please let your
pharmacist know

Some drugs and medicines
can interfere with your
baby’s development

Your baby’s health and
safety is important to us too

Marcn.o f bimes

ember, Maryland Pharmaceutical Associati

Dictionary of Drug Names

The new, fully cumulative 1983 edition of USAN
and the USP Dictionary of Drug Names has been pub-
lished by the United States Pharmacopeial Convention.
This 20th Anniversary edition of the dictionary has 709
pages and a trim size of 8-4” x 11” and it lists more than
18,000 entries, exclusive of cross-references and the
appendixes. All U.S. Adopted Names (USAN) released
from June 15, 1961, when the USAN program began,
through June 15, 1982, are included.

USAN are adopted by the U.S. Adopted Names
Council, which is co-sponsored by the American Medi-
cal Association, the American Pharmaceutical Associa-
tion, and the Pharmacopeial Convention, with partici-
pation also by the U.S. Food and Drug Administration.

Wide Coverage of International
Nonproprietary Names

For the first time, all international nonproprietary
names (INN) published by the WHO from the start of
the INN program in 1953, through 1981 are included;
4197 INN are thus represented. As a complement to the
policy of covering all INN, more than 2300 graphic for-
mulas relating to INN are included in USAN 1983. No
other publication is known that provides this entire
body of information on INN in one book. This feature is
viewed as enhancing the usefulness of USAN and the
USP Dictionary of Drug Names to both domestic and
international subscribers.

More Than 18,000 entries

In addition to the 2104 USAN and the 4197 INN, the
book includes more than 5100 brand names of re-
search-oriented firms; 2650 investigational drug code
designations; official names of USP XX and NF XV
articles with their chemical names and graphic formu-
las; and other names for drugs, both current and retro-
spective.

The main alphabetic section of the book is followed
by lists of CAS (Chemical Abstracts Service) registry
numbers and NSC (National Cancer Institute) numbers.
The USAN and USP and NF names are cross-indexed
by pharmacologic-therapeutic categories. Three appen-
dixes cover Guiding Principles for Coining U.S.
Adopted Names for Drugs; Molecular Formulas and
Corresponding USAN or Other Names; and Names and
Addresses of Domestic Firms Concerned with Com-
pounds for Which USAN Have Been Selected.

Orders for the new edition of USAN/USP-DDN
should be addressed to the USAN Division, USP Con-
vention, Inc., 12601 Twinbrook Parkway, Rockville,
MD 20852. The price is $35.00 per copy, with quantity
discounts for eleven or more copies.

26

Pharmacists Prescribe
Appropriately Study Shows

In the first study to emerge from a five-year Califor-
nia pilot project permitting drug prescribing by pharma-
cists, a team of California researchers report in the
September American Journal of Hospital Pharmacy
that pharmacists prescribed drugs for psychiatric inpa-
tients as safely and appropriately as physicians.

A panel of four clinical judges independently evalu-
ated the appropriateness of drug prescribing of three
certified pharmacist prescribers and two psychiatrists
over a one-year period at a 40-bed mental health facility
in California, according to Glen L. Stimmel, Pharm.D.,
of the University of Southern California School of
Pharmacy, and his associates.

The pharmacist prescribers were assigned diagnosed
psychiatric inpatients whose treatment plan was
primarily pharmacologic. For each prescriber, 60 pre-
scriptions were randomly selected to include 20
neuroleptic drugs, 20 anticholinergic drugs (used to al-
leviate the Parkinson-like syndrome induced by
neuroleptic drugs), and 20 antidepressant drugs.

A prescription evaluation form was designed to ac-
cess the quality of prescribing for six variables. Four
expert clinical judges, who were not associated with the
project or the mental health center, individually evalu-
ated each prescription based on American Psychiatric
Association criteria.

When scores for all three drug classes were com-
bined, one scale showed no difference while pharma-
cists’ scores were better on five of six scales and when
all six scales were combined.

The study shows that pharmacist prescribers actually
outperformed physicians in appropriately prescribing
certain classes of drugs. Since the scores for all pre-
scribers in most areas were in the appropriate range, the
authors emphasize that it is not possible to claim clini-
cally important differences among the prescribers.

The investigators conclude that pharmacists’ pre-
scription orders for psychiatric inpatients were as ap-
propriate as physicians’ orders.

The authors recognize that several limitations in the
design and execution of the study should be considered.
While these findings cannot be extended to all pharma-
cists, this report supports earlier studies of clinical
pharmacy services in skilled nursing facilities and other
institutional settings that indicate that a substantial
amount of patient care can be provided by clinical
pharmacists in cooperation with physicians.

The American Journal of Hospital Pharmacy is the
official monthly publication of the American Society of
Hospital Pharmacists.

THE MARYLAND PHARMACIST

ak le Ck d

Dr. David Roffman participated in the Over 100 Pharmacists attended this first CECC program of the new
October 3rd Continuing Education Coor- season. It was designated the Henry Seidman Memorial Lecture.
dinating Council Program on Cardiovas-

cular Drugs which was held at the new

Baltimore Hyatt Regency Hotel.

5 Za
i 2 .. 2

: 4
EPR. Be : : a : i : aN ‘ A © .
The Frederick County Pharmaceutical Association met recently The Basement of the Kelly Building has been the site of several
and installed its new officers. They are; Jim Rutten, President; Pharmacy related parties, fraternity rushes and social gatherings
Mary Green, President-elect; Don Ceccorulli, 1st Vice President; as the School of Pharmacy begins the new school year.

Mel Sollod, 2nd Vice President; Dan Mackley, Secretary-Treasurer.

This page donated by
District-Paramount
Photo Service.

DISTRICT PROTO ING

10501 Rhode Island Avenue
Beltsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

NOVEMBER, 1982 Zi

Pictures courtesy Abe Bloom — District Photo

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

TRIENTINE:

Patients with Wilson’s disease are usually treated
with penicillamine (Cuprimine) to chelate copper in
their plasma and thus control the development or
exacerbation of symptoms of copper toxicity. Ap-
proximately 10% of the patients treated with this drug
will develop a form of immunological intolerance to the
agent and demonstrate symptoms which may include
lupus, hemolytic anemia and/or nephritis. Trientine is a
new chelating agent which has been used successfully to
treat patients who were unable to tolerate penicillamine
therapy. Lancet, Vol. I, #8273, p. 643, 1982.

CHOLESTEROL:

A synthetic peptide has been used to act as a deter-
gent to dissolve lipids and activate the letithin-
cholesterol acyltransferase enzyme system which is
necessary for the mobilization of body cholesterol. The
peptide (LAP-20) contains 20 amino acids and has been
used successfully in animal experiments. The drug will
be studied in man to see if it might have toxic and/or
antigenic action before extensive testing can be con-
tinued. J Am Med Assoc, Vol. 247, #11, p. 1539, 1982.

ESSENTIAL HYPERTENSION:

Captopril (Capoten) was administered to hyperten-
sive patients and responses were monitored. Patients
who did not adequately respond to this therapy were
given either a beta adrenergic blocking agent or a
thiazide diuretic. The effect of the beta-adrenergic
blocking agent was minimal as expected, suggesting that
the hypertension was unrelated to renin release or an-
giotensin II excess. Thiazide diuretics are more effec-
tive in patients who respond only minimally to captopril
therapy. Br Med J, Vol. 284, #6317, p. 693, 1982.

IRON CHELATION:

Desferrioxamine B (Desferal) is used to reduce the
plasma concentration of iron in cases of toxicity. Sev-
eral agents, derivatives of pyridoxal, have been found to
have value in these situations. Initial studies indicate
that the new drugs may be more effective than desfer-
rioxamine in removing excessive iron from the body.
Pharmacol Exp Ther, Vol. 221, #2, p. 399, 1982.

LEPROSY:

The therapy for leprosy varies in different locations.
A new regimen has been developed which has been
proven to be as effective as most currently used pro-

28

grams, but is not as expensive. Rifampin is used in a
single monthly dose of 1200 mg and dapsone is used ona
daily basis. If necessary, clofazimine may be added to
increase the likelihood of remission. Lancet, Vol. 1,
#8283, p. 1199, 1982.

VALPROIC ACID:

Since aspirin displaces phenytoin (Dilantin) from
binding sites on plasma proteins, it was of interest to see
if the same effect was present when aspirin was admin-
istered to patients receiving long-term valproic acid
(Depekene) therapy. Studies conducted in children in-
dicate that aspirin will not only displace the anticonvul-
sant from its binding site on plasma protein, but it also
may interfere with its metabolism. Patients using val-
proic acid for long periods might show signs of toxicity
if aspirin is ingested. Lancet, Vol. I, #8283. p. 1199,
1982.

DIAZEPAM:

Chlordiazepoxide (Librium) has been used to reduce
the discomfort associated with alcohol withdrawal, so
studies were designed to test the effectiveness of
diazepam (Valium) in this situation. Animal studies in-
dicate diazepam is a safe alternate to chlordiazepoxide
in suppressing signs of alcohol withdrawal. J Pharmacol
Exp Ther, Vol? 221, #2; p- 319, 1982.

AZATHIOPRINE:

Chronic ulcerative colitis may be unresponsive to
various therapeutic regimens. This has prompted inves-
tigators to use azathioprine (Imuran) in a double-blind
study to see if it might be of value in this condition.
Although nausea was commonly seen as a side-effect,
the researchers felt that the efficacy of the drug has now
been established and that it be considered for use in
patients who are refractory to normal therapy and for
whom surgical treatment is inappropriate. Br Med J,
Vol, 284, #6325, p. 1291, 1982.

MALARIA:

Patients exhibiting symptoms of malaria were ex-
amined and found not to have the malarial parasite pres-
ent in their blood cells. Normally this would exclude
the possibility of the disease, but further studies found
the condition to exist. The patients in question were
surveyed and were found to have taken cotrimoxazole
(Bactrim, Septra) prior to admission. Trimethoprim, a
component of the combination, was originally used as
an antimalarial and apparently complicated the diagno-
sis by removing the parasite, but not completely

THE MARYLAND PHARMACIST

eradicating the condition. Patients with symptoms of
malaria and a history of cotrimoxazole therapy should
be considered as having malaria until additional tests
indicate otherwise. Br Med J, Vol. 284, #6239, p. 1616,
1982.

QUINIDINE-DIGOXIN INTERACTION:

Most of the digoxin (Lanoxin) administered is found
to be excreted in the urine unchanged. Concomitant
administration of quinidine increases digoxin levels via
several postulated mechanisms, including displacement
of the glycoside from tissue binding sites, decreased
vascular volume, and reduced renal clearance. Inves-
tigators now postulate another possible mechanism.
They suggest that quinidine may interfere with the
extra-renal secretion of digoxin in the gastrointestinal
tract. J Pharm Pharmacol, Vol. 34, #4, p. 280, 1982.

RECOMBINANT LEUCOCYTE A INTERFERON:

Interferon has been prepared for human use via
biosynthetic techniques. Studies conducted in 16 pa-
tients show almost half of the patients experienced ob-
jective evidence of tumor regression while receiving the
hormone. Side-effects included chills, myalgias,
headache, fatigue, and reversible leucopenia and
granulocytopenia. Ann Intern Med, Vol. 96, #5, p. 549,
1982.

RESPIRATORY RATES IN ELDERLY:

Measurement of respiratory rates in elderly patients
may be useful as an indicator of lower respiratory infec-
tions. Normal rates of 16 to 25 respirations per minute
were found to be associated with all types of infections,
but elevated respiratory rates were found to proceed
clinical signs when a lower respiratory tract infection
was present. Determining respiratory rates in the el-
derly may be a valuable and simple method of predicting
the presence of a lower respiratory tract infection. Br
Med J, Vol. 284, #6316, p. 626, 1982.

DIFLUNISAL:

Diflunisal is a salicylate derivative which was dis-
covered while searching for a more effective and less
toxic salicylate. The drug is said to be more effective
than aspirin and has a longer plasma half-life. MSD is
marketing the drug under the name of Dolobid. J Clin
Pharmacol, Vol. 22, #2, p. 89, 1982.

NAPA:

Procainamide (Pronestyl) is metabolized to an active
antiarrhythmic agent, n-acetyl procainamide (NAPA).
This metabolite does not accumulate in therapeutic
concentrations if renal function is normal, but it may be
found in excessive amounts in those patients ex-
periencing renal impairment. When using evaluative
techniques to measure the amount of the antiarrhythmic
agent in patients with renal problems, one must be
aware of the presence of this metabolite and adjust the
dose of the parent compound to account for its pres-
ence. Clin Pharmacokinet, Vol. 7, #3, p. 206, 1982.

NOVEMBER, 1982

ANTIDEPRESSANT THERAPY:L

Patients with pre-existing chronic heart disease are
often not considered for tricyclic antidepressant therapy
because of the cardiovascular toxicity associated with
the use of these agents. Studies indicate that tricyclic
antidepressants can be used safely in patients with car-
diac dysfunction as long as the impairment is not se-
vere. They feel much of the concern over the use of
these drugs in patients with cardiovascular problems
has resulted from problems which have occurred when
the medication was taken in overdoses. N Engl J Med,
Vol. 306, #16, p. 954, 1982.

CAFFEINE:

Birth defects may be caused by a large variety of
substances. Caffeine is a drug frequently ingested dur-
ing pregnancy so its effect on fetal development was
studied. No correlation between caffeine ingestion and
teratogenic effects was noted. J Am Med Assoc, Vol.
247, #10, p. 1429, 1982.

CEFTAZIDIME:

Another cephalosporin derivative has been synthe-
sized which has been found to be active against Pseu-
domonas in immunocompromised patients. It gained
access to pus, sputum, and bile in sufficient concentra-
tions to produce a therapeutic effect. Much work is
being done in an effort to find an alternative to amino-
glycoside therapy for the treatment of Pseudomonas
aeruginosa. Lancet, Vol I, #8282, p. 1152, 1982.

WOMEN ATHLETES:

Women who participate regularly in long distance
running events may experience a decrease or cessation
in menstruation. While studying a group of amenorrheic
women, it was noted that premature bone loss may be
associated with this condition. Women athletes have
little fatty tissue and a low level of estrone. Estrone is
synthesized from the adrenal hormone androstenedione
in the fatty tissue and since fatty tissue is lacking, es-
trone synthesis is diminished. Decreased estrogen con-
centrations are thought to play some rule in os-
teoporosis associated with the post menopausal state
and so prospective studies are being conducted to de-
termine if bone density decreases in women athletes.
J Am Med Assoc, Vol. 248, #5, p. 513, 1982.

CIMETIDINE AND ANTACIDS:

Antacid therapy is sometimes used in conjunction
with cimetidine (Tagamet) administration in efforts to
reduce discomfort associated with ulcer disease.
Studies conducted in Washington, D.C. indicate that
most commonly used antacids will inhibit the absorp-
tion of the H-2 antagonist and thus reduce its efficacy.
The authors of this article suggest that cimetidine not be
given concomitantly with an antacid, that antacids may
be given one hour before or after cimetidine administra-
tion in the fasting state or one hour after the drug is
given in the fed state. N Engl J Med, Vol. 307, #5, p.
400, 1982.

29

Your computer future begins at 3PM

Let's think about your pharmacy business. Lots of
developments...just in the last year. New
regulations, products, procedures. New
merchandising demands. The competition has
crowded in. Profit margins have been difficult to
hold. Everything is changing. And now, it’s in-
house computers. Not just a change. A revolution!
Mounting paperwork, increasing professional
demands and the growing cost burden of
accounting and management reporting have
forced your pharmacy into the computer era. Buf,
just how will these rnachines handle the changes?
Will the computer system you select mold itself to
your business or will it just grow old fast?

Growth and flexibility can be built into a
computer system, but must be supported with
continuous software back-up. That takes long-term
commitment to the pharmacy industry. Shop for
that commitment. Check out computer
companies, not just computer systems. Look at.
company track records.

3 P.M. Inc. is a ten-year pioneer of computer
solutions for the pharmacy industry, the nation’s
largest processor of third party drug claims and
the most complete provider of computer services
tothe pharmacy profession. 3 PM. has committed
thec |, staff and expertise todeliverlong

Our stand alone system, starting at under
$20,000, utilizes Digital Equipment Corporation
(DEC) hardware — and is serviced by over 14,000
DEC service reps. All programming is in standard
DEC language.

We can provide a complete in-house pharmacy
system that handles retail operations, nursing
home service, multiple store operations, accounts
receivable, accounting and management systems,
and point of sale terminal applications. Features
include complete alphabetical search, drug
interaction and allergy updates, drug utilization
and inventory control, and complete third party
edits and OES

Tapping into 3 P.M’s central computer, our stand
alone system offers automatic weekly price
updates and centralized tape-to-tape third party
claims processing. This unique computer-to-
computer capability is the reason pharmacists
call the 3 P.M. system “the stand alone that’s not
alone.” Call today for more information.

Classified Ads

MARYLAND

Classified ads are a complimentary PHARMACEUTIC
: ASSOCIATION
service for members.

An attractive metal pin is available from the Centennial Celebration
Committee. This yellow, white, gold and red colored commemorative
lapel pin is available from the Association for only $5.00. Proceeds
will help fund the activities of the Centennial Committee. Order
yours now from the Association office.

HOTLINE NUMBERS FOR
IMPAIRED PROFESSIONALS

Physicians 467-4224

Dentists 796-8441
Attorneys 685-7878
Nurses 467-3387

wo 2

ACTUAL SIZE

Pharmacist Insignia
PATCH NOW AVAILABLE

The new emblem for pharmacists utilizing the “P.D.” designa-
tion has arrived. Designed to be sewn on dispensing jackets,
these new insignia are embroidered in dark blue with a white

background, and cost $1.50 each.

7. TITLE OF PUBLICATION A PUBLICATIONNO [2 DATE OF FILING ‘|

To order, send check or money order for emblems @ $1.50 Retr ieta phacnactee | Ag ae al 9/30/22
each to: 3. FREQUENCY OF ISSUE A Renn rime PUBLISHED 8 ocaal SUBSCRIPTION

tiont':1 le >10
Maryland Pharmaceutical Assn. t 4 COMPLETE MAILING ADDRESS OF KNOWN OFFICE OF PUBLICATION (Street, City, County, State and ZIP Code) (Not printers)

650 W. Lombard St. 650 y. Lom ard sty a -1tinar>, - .eG 21201 wt
Baltimore, Md. 21201 5S. COMPLETE MAILING ADDRESS OF THE HEADQUARTERS OR GENERAL BUSINESS OFFICES OF THE PUBLISHERS (Not printers)

U.S. POSTAL SERVICE

STATEMENT OF OWNERSHIP, MANAGEMENT AND CIRCULATION

650 «. Lombarc Str , aitisorr, far Jard 21201

a
@ FULL NAMES AND COMPLETE MAILING ADDRESS OF PUBLISHER, EDITOR, AND MANAGING EDITOR (This Item MUST NOT be blank) 7

PUBLISHER (Name end Complete Mailing Address)

Maryland */aruaccutical «ssociation, v0 .., Lowvard St., Maltimore, Md. 21201
EDITOR (Neme and Complete Malling Address) |
Davia A, wanta, 650 3. Lowbaro Street, .altinore, maryland 21201
Ca le Nn da [ MANAGING EDITOR (Name and Complele Mailing Address)
Sater Z sane
7. OWNER (/f owned by # corporation, its name and address must be stated and also immediately thereunder the names and addresses of stockholders
owning or holding 1 percent or more of total amount of stock. If not owned by a corporation, the names and addresses of the individual owners must
be given. If owned by a partnership or other unincorporated firm, its name and address, as well as that of each individual must be given. If the publica-
tion is published by # nonprofit organization, its name and address must be stated.) (/tem must be completed)
FULL NAME COMPLETE MAILING ADDRESS
Nov b 4 7 S Ph R . ] € ti Maryland °harwacvutica) sssociation 650... Lombard Street
ember APhA Regional Convention, Pe ERE SoTeS eee
. Ae 5 |
November i ° nC) | ( ( ounseling ( If stal ( 1t Mar- & KNOWN BONDHOLDERS. MORTGAGEES. AND OTHER SECURITY HOLDERS OWNING OR HOLDING 1 PERCENT OR MORE OF
9 TOTAL AMOUNT OF BONDS, MORTGAGES OR OTHER SECURITIES (If there are none, 80 state)
. FULL NAME COMPLETE MAILING ADORESS
riott lp
November 14—*‘Diabetes’’ Columbia Hilton, CECC oe
2
th
Program as

9 FOR COMPLETION BY NONPROFIT ORGANIZATIONS AUTHORIZED TO MAIL AT SPECIAL RATES (Section 411.2 OMM only)
The purpose, function, and nonprofit status of this organization and the exempt status for Federal income tax purposes (Check one)

1) (2)

November 14—Alumni Association Dinner Meeting
November 30—‘‘ Vitamin Marketing”’ Atlantic City, PaECeNaie: MON TISiaA REG EDialas MONTHS Dees oil de sisscneat | aaa ean

: AVERAGE NO COPIES EACH ACTUAL NO. COPIES OF SINGLE
10. EXTENT AND NATURE OF CIRCULATION ISSUE DURING PRECEDING ISSUE PUBLISHED NEAREST TO

New Jersey Soe eT

A TOTAL NO. COPIES (Ned Pres Run)

February 13—BMPA Dinner Dance =e — sit

1. SALES THROUGH DEALERS AND CARRIERS, STREET
VENDORS AMD COUNTER BALES

March 13—‘*‘Communications and the Elderly’’ Cen- = mt esecneron
ter for Aging, MPhA en ee
March 27—‘‘Arthritis’’ Ramada Inn, Baltimore, o ge ermine wa, carmen on oren means
CECC Program € TOTAL oWTAMUTION uno © wt

F. COPIES NOT DISTRIBUTED
1. OFFICE USE, LEFT OVER, UNACCOUNTED, SPOILED
AFTER PRINTING

Every Sunday Morning at 6:30 a.m. on WCAO-AM and 8:00 a.m. on pes SEALS tet eS a\\ 1409 1705
WXYZ-FM, listen to Philip Weiner broadcast the Pharmacy Public | nandrone phair oF eon. romionea] pumas

| certify that the statements made by MANAGER eins wi
Relations Program ‘‘Your Best Neighbor,” the oldest continuous re

none none

me above are correct and complete \ Wud) K Ly
ate, Hy

public service show in Baltimore. duty toes 3888 (See Instruction on revarse) events

NOVEMBER, 1982 a]

iZ\ age as

THE

INDEPENDENT
PHARMACISTS’
SURVIVAL KIT

¢ GROUP BUYING POWER
e PERSONALIZED CIRCULARS AT PEAK SELL PERIODS
¢ GOOD MERCHANDISE MIX ¢ COMPETITIVE PRICING

e RADIO PROMOS ¢ WINDOW SIGNS e¢ POINT OF SALE SIGNS
e MFGS. ACCRUED CO-OP ADVERTISING ALLOWANCES!

ASTRO IS ON THE MOVE!

For information on our complete advertising program - phone 467-2780

THE DRUG HOU SE 901 CURTAIN AVE., BALTO., MD. 21218
INC. Ask for Gary McNamara

An Alco Standard Company

inte
MARYLAND
PHARMACIST
Official Journal of
The Maryland

EU ria Cal
Associatio

December, 1982
VOL. 58
NO. 12

HONOS
fa’

PHARMACY

‘(MARYLAND PHARMACEUTICAL ASSOCIATION

1882-1982

Official List of Members
During the Centennial Year

THE MARYLAND PHARMACIST

650 WEST LOMBARD STREET
BALTIMORE MARYLAND 21201
TELEPHONE 301/727-0746 Ne

DECEMBER 1982 VOL. 58 NO. 12

DAVID A. BANTA, Editor
BEVERLY LITSINGER, Assistant Editor
ABRIAN BLOOM, Photographer

CONTENTS Officers and Board of Trustees
1982-83
5 President’s Message Honorary President

WILLIAM J. KINNARD JR., Ph.D. — Baltimore

. : ; President
4 USP Tips on Detecting Tampering MILSON SAPPE, P.D. — Baltimore

Vice-President

6 Honor Role of Members During the Centennial Year WILLIAMC. HILL, P.D. — Easton
Treasurer
MELVIN RUBIN, P.D. — Baltimore

Executive Director

20 What You Should Know About Commerical Armed

Robbery DAVID A. BANTA, C.A.E. — Baltimore
Executive Director Emeritus
-Da— Balti
Abstracts NATHAN GRUZ, P.D altimore

TRUSTEES

PHILIP H. COGAN, P.D.—Chairman
Laurel
DEPARTMENTS RONALD SANFORD, P.D. (1985)
Catonsville
3 l Calendar ahen TERBORG, P.D. (1985)
erdeen
: GEORGE C. VOXAKIS, P.D. (1984)
31 - Classified Ads Baltimore
LEE AHLSTROM, P.D. (1984)
25 Letters to the Editor Edgewater
MADELINE FEINBERG, P.D. (1983)
Silver Spring
DONALD SCHUMER, P.D. (1983)

Baltimore

EX-OFFICIO MEMBER

ADVERTISERS WILLIAM J. KINNARD, JR., Ph.D. — Baltimore

] HOUSE OF DELEGATES
16-17 Boots 18 Maryland News Distributing ae
19 District Paramount Photo 27 Mayer and Steinberg eee : .
32. The Drug House 31 Selby Drug Co. SON MeN bth sie SUNN INE:
30 Eli Lilly and Co. 15 Upjohn Vice Speaker
14 Loewy Drug Co. HARRY HAMET, P.D. — Baltimore

Honorary President
Change of address may be made by sending old address (as it appears on your journal) and I. EARL KERPELMAN. P.D. — Salisbury

new address with zip code number. Allow four weeks for changeover. APhA member — F
please include APhA number. President

BERNARD B. LACHMAN, P.D. — Pikesville
The Maryland Pharmacist (ISSN 0025-4347) is published monthly by the Maryland Phar- ESTELLE G. COHEN, M.A. — Baltimore
maceutical Association, 650 West Lombard Street, Baltimore, Maryland 21201. Annual LEONARD J. DeMINO, P.D. — Wheaton
Subscription — United States and foreign, $10 a year; single copies, $1.50. Members of the RALPH T. QUARLES, SR., P.D. — Baltimore
Maryland Pharmaceutical Association receive The Maryland Pharmacist each month as ROBERT E. SNYDER, P.D. — Baltimore
part of their annual membership dues. Entered as second class matter at Baltimore, Mary- ANTHONY G PADUSSIS P.D. — Timonium

land and additional mailing offices. Postmaster: send address changes to: The Maryland
Pharmacist, 650 West Lombard Street, Baltimore, Maryland 21201.

PAUL FREIMAN, P.D. — Baltimore
PHYLLIS TRUMP, M.A. — Baltimore

2 THE MARYLAND PHARMACIST

President's Message

Remember the story of the shepherd, his neighbors and a wolf and how
he cried ‘“‘wolf’” once too often. A good parable but I seem to remember another
that I read somewhere.

Visualize a peaceful land many many years ago; endowed with all the
things a people would want, a chance to work, a chance to make a good living
and a chance to raise a family. This land was called Pharmacopia. The inhabit-
ants being called Pharmers worked 10—12 hours a day and so prospered,
bringing each family peace, self respect and good fortune. The Pharmers were a
close-knit society helping each other when circumstances dictated and ev-
eryone knew everyone else. Descendent followed descendent and things gener-
ally went well except for occasional marauding packs of wolves that attacked
the sheep and cattle. Then the Pharmers would band together and repel these
attacks and life would go on again. But as years followed years something
gradually was lost to these people. They became self-satisfied, complacent and
thought so much more of their creature comforts. Some started decorating and
enlarging their carts as symbols of stature while others added more oxen to give
them more horsepower. A few went so far as digging large holes behind their
huts and filling them with water to give relief during the hot summers. Not many
relished the gruelling work and long hours of dedication needed to hold on to
what their fathers had enjoyed. Pharmer no longer knew Pharmer and so fewer
banded together to fight the marauding wolves. Most thought, ‘“‘why fight?”’
The wolves only take a few sheep, we still have enough. It did not seem worth
the effort. As most of you can imagine the good life started to disappear, the
wolves became many and the will to resist dwindled. The Pharmers gathered
together no more but remained on the farms preserving what remained of a
good and honorable occupation until everything was devoured.

I understand that discovered in the hut of the old wise man who told this
story was written an epitaph on the wall: ‘‘qualis vita, finis ita’’—Translated
freely—As you spend your life, so the end will be.

Oey

PRESIDENT

DECEMBER, 1982

What the Consumer Should Know

USP Tips on Detecting
Tampering

The recent deaths from the deliberate introduction
of cyanide into a medicine have made us all aware that
no matter how good a program of drug testing, regula-
tion, and protective packaging may be devised, total
security cannot be provided against all of the pos-
sibilities that sick minds may invent to tamper with our
medicines or other consumer goods.

Although new protective packaging requirements
doubtless will be developed, the following information
is offered to help detect any possible tampering with
over-the-counter (OTC) medicines.

Protecting Yourself

The first step in protecting yourself is an awareness
that tampering, although probably very rare, may
occur. Then it’s up to you to apply some common
sense. Here are some general suggestions.

@ Take a few seconds to visually inspect the outer
packaging of the drug product before you buy it
and again as you first open it at home.

e Don’t take medicines that show even the slightest
evidence of tampering or don’t seem “‘right’’.

e@ Never take medicines in the dark or in poor
lighting. Look at the label and the medicine every
time you take a dose.

® When selecting a drug product consider, among
other factors, how it is packaged. If the medicine
has a protective packaging feature, it should be
intact. Some examples of packaging which may
help deter tampering include:

Package Type Description

Film wrappers Film wrapped and sealed
around the drug dosage form

and/or its container.

Blister/strip packs Individually sealed dosage

units.

Bubble packs Product and container sealed in
plastic, usually mounted on/in
a display card.

Shrink seals/bands Bands or wrappers which fit
tightly around cap and con-

tainer.

Reprinted from *“‘About Your Medicines Newsletter’’ © USP

Convention, permission granted.

4

Foil, paper, or Sealed individual packets.

plastic pouches

Paper or foil sealed to bottle
mouth under cap.

Bottle seals

Paper or foil sealed over carton
flap(s) or bottle.

Tape seals

Plastic or metal caps, parts of
which must be broken to re-
move.

Breakable caps

Checking Your Medicines—Here are some tips
Packages

e Are there bits of paper or glue on the rim of the
container, indicating there once had been a bottle
seal?

@ Does the cotton plug or filler in a bottle appear to
have been removed and put back?

e Are there breaks, cracks, or holes in the outer
wrapping or protective cover or seal?

@ Does the outer covering appear to have been
disturbed, unwrapped, or replaced?

e@ Is the bottle over-filled or under-filled?

@ Does a plastic or other shrink band around the
top of a bottle appear distorted or stretched, as
though it had been rolled down and then put back
into place? Is the seal missing? Has the band
been slit and retaped?

e Is the cap on an unsealed container tight?

e Are the instructions wrinkled, misplaced, or
missing?

e Is the information and the lot number on the
container the same as that on its outer wrapping
or box?

Liquids

e Is it the usual color and viscosity?

e Liquids should not have particles in the bottom
of the bottle or floating in the solution.

@ Normally clear liquids should not be cloudy.

e@ Does it have a strange or different odor (for
example, bleach, acid, gasoline-like, or other
pungent or sharp odor)?

e All eye drops are required to be sealed at time of
manufacture to protect their sterility and indicate
evidence of any opening.

THE MARYLAND PHARMACIST

Tablets

e Has their appearance changed: Is the color dif-
ferent? Do they have unusual spots? If they nor-
mally are shiny and smooth, are some dull or
rough?

e@ Do the tablets have a strange or different odor or
taste?

e Are the tablets moist rather than dry?

Are the tablets all the same size and thickness?

e If imprinted, do all tablets have the same im-
print? Is the imprint missing from some?

Capsules

e@ Are they cracked or dented?

@ Do they have their normal shiny appearance or
are some dull or have fingerprints on them as
though they have been handled?

e If imprinted, do they all have the same imprint?
Is the imprint missing from some?

e@ Are they of uniform size and color?

@ Do the capsule contents appear to be equally
filled? Are the capsules all the same length?

e@ Do they have an unexpected or unusual odor?

Tubes and Jars (Ointments, creams, pastes, etc.)

@ Check the bottom as well as the top of a tube,
especially if it is a metal tube crimped at the bot-
tom like a toothpaste tube. It should be firmly
sealed.

e Are ointments and creams smooth and non-
gritty? Have they separated?

Keep in mind that not every change in the appear-
ance or in the condition of a product means that the
package has been tampered with. The manufacturer
may have changed the color or the packaging of a
medicine or the product may be experiencing deteriora-
tion or may have experienced rough or unusual handling
in shipping. Also, some minor product variations may
be normal.

Whenever you suspect anything to be out of the or-
dinary or unusual about a medicine or its packaging,
have your pharmacist look at it. Pharmacists know what
the usual appearance of the packaging and the product
should be. If there are genuine problems with a drug
product or a medical device, your pharmacist may re-
port it to the Drug Product Problem Reporting Program
(DPPR), which is coordinated by USP and funded by
FDA, with the cooperation of the American Society of
Hospital Pharmacists and state pharmacy associations.

DECEMBER, 1982

ACA RELEASES
MINI-BOOKLETS FOR
COMMUNITY
PHARMACY MANAGEMENT

The American College of apothecaries announces the
completion of four mini-booklets, written to assist
community pharmacy practitioners to manage the
community pharmacy. Two additional booklets are
planned and will be released in the near future.

The four booklets presently available are:

@ Guidelines For Prescription Pricing

@ Guidelines For Locating a Pharmacy Practice
@ Guidelines For Financial Planning

@ Guidelines For Inventory Control

For more information contact:
The American College of Apothecaries
Publications Director

874 Union Avenue
Memphis, Tennessee 38163

(901) 528-6037

Smoking Clinic Available

For those smokers interested in quitting, the Ameri-
can Lung Association of Maryland offers a FREEDOM
FROM SMOKING Clinic as well as a self-help pro-
gram. Both programs have been thoroughly researched
and tested.

The FREEDOM FROM SMOKING Clinic, taught
by a trainéd volunteer facilitator, consists of an orienta-
tion and seven two-hour sessions. Behavior modifica-
tion and group support techniques are used to help the
smoker make the transition to becoming a nonsmoker.
The $25 fee provides for handouts, a comprehensive
maintenance manual and a relaxation cassette tape. Ar-
rangements can be made to hold the clinic in a business
or community setting.

The FREEDOM FROM SMOKING self-help pro-
gram, designed to help smokers quit on their own, con-
sists of two manuals, a step-by-step quitters manual
called, ‘‘Freedom From Smoking In 20 Days’ and a
maintenance program for the new ex-smoker, known as
“A Lifetime Of Freedom From Smoking’’. Behavior
modification and self-monitoring techniques are the
basis for the self-help program. The fee for the self-help
manuals is $7.00.

For information about our stop-smoking programs
contact the American Lung Association of Maryland at
685-6484 or 1-800-492-7527.

We care about every breath you take.

Honor Role of Hemebers
During the Centennial Year

Hillel Aarons

Janet M. Abramowitz
Marvin H. Abrams
Lawrence Abrams
Alfred Abramson

Siu Y. Adams

Mary A. Addae
William J. Addicks
Stanton G. Ades
George J. Agris

Lee Ahlstrom
Lawrence Aiken
Benjamin F. Allen
Elwin Alpern

Arnold Alperstein
Larry Alpert

Sherri L. Alpert
John C. Andreadaskis
Mary Therese Andres
Jerome Angster

Max Ansell

Clarance Anstine
Christopher Apesos
Dimitrios Apostalou
Michael J. Appel
Olushula Tinuke Aribisala
Marilyn I. Arkin
David M. Arrington
Stanley J. Ash
Zenaida C. Asuncion
Paramaz Avedisian
Stuart Axelrod

John J. Ayd

David H. Ayres
Caroline T. Bader
Adolph Baer

Halcom S. Bailey
Daniel S. Baker
John H. Balch
Michael D. Ball
Stuart L. Baltimore
Vincent C. Bambrick
Margaret A. Bare
Nancy Baros

Barbara C. Barron

6

Jack Barshack

John B. Batdorf
William H. Batt
George Battersby
Cynthia Rutten Bavry
Richard Baylis
Gerald E. Beachy
Sandra L. Becker
John P. Beckley
John A. Beckman
Barbara B. Bedell
Vahram Bedrossian
Lawrence H. Beker
Edward A. Bell
James Joseph Bellay
Ruth Bendler

Thomas L. Bennett

Charles W. Bennett, Jr.

Martin K. Bennett
Eric Von Bergen, Jr.
Alan B. Berger
Jerome A. Berger
Robert S. Bergstein
Abraham Berman
Charles V. Bernard
Brian Berryhill
Robert E. Beyer
Alex Bigman

Jacks Dee iLEby
Patrick H. Birmingham
Diane M. Black
Franklin Blatt

Ruth Blatt

Arnold Blaustein
Michael N. Blazejak
Jerome Block

Frank Block

Abe Bloom

Barbara M. Blue
Sahr Lebbie Bockai
Philip Bogash
George Bohle

Morris Bookoff
Morris H. Bortnick
Howard A. Bovell

Cynthia J. Boyle
Antoinette Bozievich
Leroy Bradley
Maurice B. Brager
Howard Bragg

Barbara Brasher
Frederick Breslin
Jerrold F. Bress
Louis J. Brill
Virginia G. Bronaugh
Phil Brooks

Joe F. Brooks
Anthony Brooks
Stanton P. Brown
Christopher L. Brown
Gerald Brunson
Francis J. Bublavek
Maryanne B. Budnichuk
Huong Thien Bui
Moses A. Bundukamara
Keith A. Burechson
Vincent P. Burkhart
Herbert J. Burns
Joseph Butera

Karen E. Caldwell
James Baird Caldwell
Paul Campbell

Robert M. Caplan
CarleeG-aGaplan
Robert Carlton
Joseph Carmel
William F. Carney
Marcus Carson

David C. Carter

Rene L. Carter

Paul M. Carter

Leon R. Catlett
Andrew T. Cavacos
BLins seChack

Mel Chaiet

Sol Chalom

Normand E. Champagne
N. W. Chandler

David Ross Chason
John E. Cheek

THE MARYLAND PHARMACIST

Louis Cherney
Robert V. Cherricks
Bernard Cherry
David Chin

Judith Chioli

Frank B. Clark
David C. Clarke
William Clatterbuck
Arnold E. Clayman
Jerome H. Clayman
Harold W. Clinkscale
Philip H. Cogan
Beth M. Cohen
Michael D. Cohen
Jack R. Cohen
Gilbert Cohen
Steven Cohen

John J. Colclough
John H. Conley, Jr.
Mary W. Connelly
William A. Cooley
Kim M. Cooper
Morris Cooper
Joseph Coradetti
Theodore Coulianos
Laurajean Councill
Anthony Courpas
James M. Crable
James P. Cragg, Jr.
Nancy R. Cramer
Joseph P. Crisalli
Terry P. Crovo
Cliff Crown
Laurianna M. Crown
John A. Crozier
James Bernard Culp
Maurice Cummings
David A. Custer
Eugene Czapiewski
Donald Dagold

David Dalton

Loc K. Dang

John 1. Daskal
Arnold L. Davidov
Saul D. Davidson
Joseph W. Davies
Richard E. Davis
Francis A. Davis
Francis K. Davis
George A. Davis, Jr.
David DeCillis

Max Deckelbaum
Julie Kennedy Deloye
Leonard J. DeMino
Dudley A. Demarest, Sr.
Dudley A. Demarest, Jr.
Karen B. Demsky

DECEMBER, 1982

Jeffrey Denholtz
Carl A. DeRito
Harry DeSantis
Vincent R. DiPaula
Stephen Disharoon
Jeffrey L. Disney
Karen Disney
Dolores Dixon

Daniel K. Doherty
Charles M. Donohue
George T. Dooley
Robert L. Doolittle
Joseph Dorsch
Margaret V. Dorsch
Joseph U. Dorsch, Jr.
John H. Dougherty, Jr.
Jamie L. Dowell
Edward Dowling

James R. Downs
Charles R. Downs
James Holly Drennen
Ruth Dunbar

Douglas E. Duncan
Kathleen A. Dunn
Charles Gilbert Dunn
Mark W. Durkin
Roberta Van Duzzer
Patricia E. Dwyer
Wayne Dyke

Dennis Lee Eaton
Betty Ebersold
Marvin L. Edell
James D. Edwards
Daniel M. Eichberg
Harry Eisentrout
Donald Elliott
Robert W. Elliott
Ross Engel

Clinton W. Englander
Geraldine Epley
Leslie M. Epstein
Cecilia Escalante
Joseph M. Eshleman
Sampson E. Esochaghi
Gerard L. Eugene
Michael J. Evanko, Jr.
Carolyn S. Evans
Kathryn Fader
Frederick W. Fahrney
Alvin Jay Fainberg
Jeffrey C. Farace
Evelyn R. Farinas
Stephen A. Farmer
Ira Fedder

Donald O. Fedder
Madeline Feinberg
Albert Feldman

Leslie Feldman
Charles W. Feldman *
Paul T. Fenton, Jr.
Glenn Feroli

James D. Finch
Jerome L. Fine
Harold Fingerhut
Francis T. Fink

John Philip Fink
Harry B. Finke
Frederick S. Firnbacher
Bernard A. Fischer
Kim P. Fisher
Raymond Foer

William T. Foley, Jr.
Denise Fonda

Mary Birchelaw Forbes
Leonard Q. Forman
Jerri Edwards Formica
Carroll P. Foster
Harold N. Frankle
Mayer Freed

Marvin Freedenberg
Gerald Freedenberg
Joseph Stafford Freeman
Emanuel G. Freeman
Paul Freiman

Joseph Freiman
Marvin Friedman

Saul Ben Friedman
Melvin Friedman
Albert J. Friedman
Irvin Friedman
Nathan Friedman
Louis Friedman
Milton A. Friedman
Stephen S. Friedman
Aaron J. Friedmann
David E. Full
DavideEul tonya te
Edward B. Furr
Nathan Futeral

Ellis Gadol

Jerome Gaine

Marvin I. Gamerman
Howard J. Gampel
Salvatore D. Gasdia
Dominic R. Gasdia
Vincent H. Gattone
Paul G. Gaver

Paul Gaver, Jr.

John J. Gazda
Herbert Geilenkirchen
Steven P. George
Simeon M. Georgiou
Simeon J. Georgiou
Milton S. Getka

Owen J. Gilliece
Benjamin Ginsberg
John J. Di Giovine
Norman Gitomer

Gill David Gladding
Henry J. Glaeser, Jr.
Abraham E. Glaser
Herman Glassband
Theodore Gleiman
Sandra Gluckstern
Irving Goldberg
Margie Mae Goldberg
Milton Goldberg
Harvey Jay Goldberg
Leonard Goldberg
Brenda Golden

Sam A. Goldstein
Mark J. Golibart
Irvin Goodman

Leon Goodman

Bruce Gordon

Hinda Gordon

Bruce M. Gordon
David M. Gottlieb
Elliot S. Gottlieb
Susan L. Gottlieb
Arnold F. Grabush
Charles M. Graefe, Jr.
Jeanne L. Graefe
William R. Grant
Godfrey S. Gray
Aaron Grebow

Ann J. Green

Lanh Green

Louis Greenberg
Morton Greenberg
Shirley Greenberg
Richard E. Greenberg
Murray G. Greenberg
Marc Greene

David D. Greenfield
James Greenwald
Ernest Gregg, Jr.
Daniel Greif
William F. Grier
Franklin R. Grollman
Warren A. Gronert
Norton J. Grossblatt
Robert J. Grossman
D. Benton Grothaus,Jr.
Nathan I. Gruz

Judy Gundel

James L. Gundling
Clifford W. Haack
Gary L. Haas
Douglas Haggerty
Steven J. Haiber

fe}

John Hale

Sam Halpern

Harry Hamet

Lenka Hamonnay-Preyer
Young Han

Mayer Handelman
Stephen Handelman
Carleton William Hanks, Jr.
William Melvin Hanna
Herbert O. Hansen
George Harman
Richard T. Harmon
Robert Harnish
George E. Harrington
William S. Harris
Dianne Harris
Gordon M. Harrison
Mark Eugene Hawes
William C. Hawk
James D. Hawkins
Cheryl J. Hawtof
Edmund M. Hayes
Edward C. Hayes
Thomas J. Hayman
Robert F. Hayward
Barry D. Hecht

Roger G. Heer

Gerald Heilman
William M. Heller

L. Louis Hen
Charles C. T. Henderson
Marvin W. Henderson
Robert W. Henderson
Irving Heneson
Sister Mary St. Henry
Steven Herlich
Norman Herman

Manuel F. Hernandez
Gerard A. Herpel
Wyatt Herrod

Selig S. Hertz

Susan M. Higgins
Manuel K. Highkin
Marian C. Hill
William C. Hill
Sheldon J. Hillman
Milton L. Hillman

Bou Gemiiil iman satis
Peter Hirsch

Dennis L. Hitchcock
Theresa J. Ho
Audrey Hodges
Ceclia Hoey

Marta Hoffman

G. Lawrence Hogue
Laurie A. Holdclaw
Hyacinth Holder

Jon Todd Holland

Marilyn A. Holland

Sol Hollander

Annamaria Homonnay-Weikel
Carville Benson Hopkins
Isadore Horwitz

Stephen Hospodavis

Mary Hubbard

George H. Huber

Thomas E. Humbert
Calvin Hunter

William J. Hutchinson
Robert R. Imbierowicz, Sr.
Robert L. Irby
Lionel H. Jacobs
Lawrence I. Jacobson
Paul Jandorf
Anthony P. Jannetta
Albert N. Japko
Arnold R. Jasinski
Lawrence Jason

Basil Peter Johns
Eric E. Johnson

Jon D. Johnson
Thomas E. Johnson
Alvin Johnson, Jr.
William J. Johnson
James W. Johnson, III
Michael F. Johnston
Marvin H. Jones

John H. Jones

Joseph J. Jordan
Carol A. Junge
Theresa K. Justice
Robert J. Kabik
Reuben Kahn

Edith Kale

Irvin L. Kamanitz
Irvin Kamenetz

Felix A. Kaminski
Catherine D. Kane
Jung J. Kang

Wannee Kankirawatana
Robert R. Kantorski
Angelique R. Kariotis
Stanley Karmiol
Philip Ee.Karnyeore
Jerome Karpa

William S. Karr
James Kasper

Joseph Kasser
Annette M. Kassolis
Kathleen S. Kastama
Morton Katz

Gabriel E. Katz
Albert Katz

Joseph Kaufman

THE MARYLAND PHARMACIST

Minor J. Kavanaugh
Linda S. Kaye

Kyung Sook Lim Kchung
Timothy Kefauver
George Riland Keller
James M. Kellner, Sr.
Charles W. Kelly, Jr.
Charles W. Kelly, Sr.
Murray Kemp

Jerold A. Kempler
Mark Kern

Earl I Kerpelman
James L. Kessell
Michael Kesselman
Jungnon R. Kim

Gary Kincel

Crystal Anne King
Kathleen B. King
William J. Kinnard
Barbara Kirby

James Kirkwood
Abraham Kirson

Donald Mark Kirson
Leon Kirszenbaum
Larissa E. Kitenko

Leonard Kramer

Jack L. Kramer

John Krantz

Frank Kratz

David Krigstein
William J. Krocheski
Norman J. Kronberg
Robert B. Kroonpnick
John A. Kudrick
Roslyn Kurland
Marvin Lachman
Bernard B. Lachman
Samuel Domenic Lagrew
Thomas D. Langston
Pamela Hill Lappen
Margaret B. Larsen
Sol Lavin

Herny W. Lawlor

Leon J. Lazarus
Gary W. Leach
Ronald E. Leaf
Charles Leary

Dean E. Leavitt
Hyman Lebson

David Lebson

Melvin G. Kitt
Sidney Klavens
Elmer Klavens
Ronald P. Kleiman
Jack S. Klein

I. Dennis Klein
David J. Kleinbart
Suzanne Klies
Bernard B. Kline
Stephen C. Kloch
Alfred Klotzman
Robert H. Klotzman
Michael J. Kolf
James E. Krahulec
Karen Santo Kram
Eric Kramer

Bonnie S. Kramer
Philip Kramer

DECEMBER, 1982

Bosco C. K. Lee
Wai L. Lee
Raymond Lee
Henry David Leikach
David Leise
Elaine L. Leo
Michael Leonard
Thomas M. Lesko
Dorothy S. Levi
Mark A. Levi
Richard Levin
Leon E. Levin
Arthur Levin
Max Levin

Barry E. Levin
Benjamin Levin
Jeffrey Levin
Norman Levin

Theodore Levin
Nathan Levin
Philip Levin
Bonnie Levin
Jerome I. Levine
Jay Levine

Monroe J. Levinson
Julius V. Levinson
Donald Levy

Mel Levy

David N. Lewinter
F. Harold Lewis
Gregory Leyko
Joseph Libercci
Samuel Lichter
Raymond Lichter
Harry S. Lichtman
Albert Lichtman
Glenn H. Lichtman
David B. Liebman
Winnie H. Lin
Philip D. Lindeman
Louis Lindenbaum
Morris Lindenbaum
Edwin L. Lipsitz
Albert Litman
Teresa J. LiVolsi

Joseph W. Loetell, Jr.

Jane K. Logan

Mary S. Long
Richard E. Long
George Losonci
John A. Losonczy
Larry R. Lowenthal
Ronald Lubman
Harry Lucia
Michael S. Luger
John Lutrell
Valentian Lvovsky
Nicholas Lykos
Charles A. Lyles
James Lyon
Bernard F. Macek
Frederick J. Mack
Frank J. Mackowiak
Ben H. Macks

Anthony J. Maggio, Jr.

John Magiros

Gary H. Magnus
Richard Mainzer
Edward R. Majchrzak
Nancy Lane Makant,

Wanda T. Maldonado-Davila

Mark Mallach
Donna E. Mallard
Leo F. Mallard
Steven J. Marcalus

Michael Marcus
Carroll P. Marinelli
Frank O. Marinelli
Melvyn Lyons Marks
Robert Jay Martin, Jr.
Robert J. Martin, Sr.
Maria Lourdes Martir
Karen J. Mason

Laura L. Maxwell
Alexander Mayer
Lieser M. Mayo
Harold H. Mazer
David P. McCagh
Edward T. McCagh, Jr.
Kevin McCarthy

Edith McCarty

David McCelland
Craig R. McCormack
Bernard C. McDougall
Linda S. McFadyen
Roland F. McGinty, Sr.
Clifford Ly McGraw
Barbara McHenry

John R. McHugh
Richard McKenna
Wilma C. McLean
Michael McMahon
Robert W. McNair

Eva A. Mead

Lori A. Mears

Atul M. Mehta

Mary Melito

Daniel Mendelsohn
James Mendelsohn

Max Mendelsohn
Thomas C. Mendelsohn
Robert Mercer
Gretride S. Merl
Stanley Merwitz
Richard A. Metz
Francis J. Meyer
Karen P. Meyers

T. Anne Meyers
Joseph F. Michaels, III
Julian I. Miden
Rudolph P. Mierisch
Ranta B. Miezia
Diane L. Mijan

Glenn R. Miles

Olga H. Miller

Jack W. Miller

James Albert Miller
Ruben Miller

Keith W. Minnick
Martin Barry Mintz
Julius Mirvis
Laxmikant Modha

10

Johnny Joseph Moffett
Robert K. Moler

Harold Mondell
Marshall G. Montgomery
N.E. Monticelli

Carla A. Mooser

Angel R. Morales

Victor H. Morgenroth, Jr. *

Alvin Morgenstein
William A. Morgenstern
James T. Morrow
Alicia M. Morrow
Joseph Morton

Betty Moses

Janet Moskitis

Milton Moskowitz
Peter Moulton

Ben Mulitz

Steven R. Mummert
Janet A. Murphy
Thomas O. Murray
Ellis B. Myers
Richard E. Myers
Richard S. Nakles
Glenn W. Nash

Jackson Nave

Stephen Needel
Matthew J. Nevins, Jr.
Elizabeth A. Newcomb
John Randolph Newcomb
Anthony Newman

Linda Newman

Albert Newman

John C. Newton

Nhung Thi Ngo

Tuong Anh Nguyen
Thong Van Nguyen

Kim Binh Nguyen

Ann Thuc T. Nguyen
Tuong V. Nguyen
Cornelia D. Nieuwoudt
Suzanne L. Nishimura
Allen T. Novak
Valentine E. Nowak
Edward Nussbaum

Paul L. O’Brien

Gary Oderda

Lynda Oderda

Marvin Oed

Kayode Babalola Ogunnaike
Albert V. Ohlendorf
Louis E. Oken

David Oken

Jack Oken

John Oliver

Bennie Owens

Harry B. Owens, Jr.

Meyer Oxman

Ryland D. Packett
John E. Padousis
Anthony Padussis
Arnold Paige
Hae-Kyung Paik

Thomas R. Palmer
Kampanart Panasethaned
Bernard Paris

Grace Gamma Park
David H. Park

Melvin Parker

Richard Parker

Joseph E. Parker
Darrel Wayne Parrish
Stacy Pass

Thomas Patrick

Marvin Pattashnick
Frank Paul

Martin T. Paul

A. Laurie St. Paul
Carol M. Paulick
Thomas Payne

Donna Peacock
William Pearlman
David Pearlman

Joseph L. Pelican
Normand A. Pelissier
Sheldon B. Pelovitz
Thomas M. G. Penn
Cynthia M. Pennete
Deborah Penrod
Philips Percy
Jolanta Weinrub Peretz
Phillips M. Perry
Christos L. Petropoulus
C. Edward Pfeifer, Jr. *
Nho Van Pham

Terri L. Pheil
Michael V. Phillips
Emerson C. Phillips
Mark E. Pilachowski
Deborah Pillsbury
Richard M. Pilquist
Bracey Michele Pinson
Robert J. Pintoff
DaviduLleseite

Alfred C. Plempel, Jr.
Robert M. Plummer
Richard J. Podliska
Elizabeth A. Poggi
James W. Polek

Reatha P. Polk

Morton Pollack
Sheldon E. Pollekoff
Murray Polonsky
William Popomaronis

THE MARYLAND PHARMACIST

Samuel Portney

Allan Posner

Charles A. Powell
Norman A. Powers
Larry Pozanek

Mark E. Prescop
Harvey B. Press
Gregory W. Price
Sherman D. Pritzker
Stanley E. Protokowicz
Stephen J. Provenza
Irving Pruce

Douglas M. Pryor
Ralph T. Quarles
Harvey Rafkin
Radhica K. Ramkission
Oscar R. Ramos
Gloria Carazo Randall
Joseph Ras

Dennis Reaver

Adele Krause Reed
Bartelett Regan
Vincent Regimenti,Jr.
Budne Reinke

Martin Reiser

Sharon M. Remmers
Bonnie Ray Rettew
Paul Reznek

Denise M. Rhodes
John Ricci

Howard S. Rice

David R. Richardson
David Richman

4

Governor Harry Hughes declared October 5, 1982 to be the Pharmacy Association Founding Day in Maryland. Shown here with the
Proclomation are: (left to right) Executive Director David Banta, Vice President William Hill, Governor Hughes, President Milton Sappe,
and Chairman of the Board Philip Cogan. Sappe presented the Governor with a Centennial Apothecary Jar and some antique prescrip-

tions.

DECEMBER, 1982

Emanuel Richman

Phil Richman

Jerome Richmond
Kathleen E. Rieve
Arthur Norman Riley
Harold Rinde

James R. Ritchie
Giselle Rivera
Gaythel Sanford Robbins
Michael C. Roberts
Zoe C. Robinson

Ann Louise Robinson
Christopher Rodowkas, Sr.
Christopher Rodowskas,Jr.
David W. Rombro
Michael J. Rombro
David M. Rombro

Jonas Rose

Stanley Leonard Rosen
Jeffrey Rosen

Donald Rosen

Leon Rosen

Leon Rosenberg

Morris Rosenberg
Robert Rosenberg
Sanford L. Rosenbloom
Jill Rosenfeld

Aaron Rosenstadt

Sol Rosenstein

Gloria Rosensweig
Allan M. Rosenweig
Alvin Rosenthal

John J. Roslyn

A. | 5 de ;

Joseph T. Ross
William C. Rossberg
Samuel J. Rostov

Rochelle Rubin Rotenberg

Ivan Isaac Rotkovitz
Irvin Ruben

Louis J. Rubenstein
Benjamin Rubin
Melvin N. Rubin
John S. Ruggiero
Ducan J. Runyon, Jr.
Joseph M. Ruppel
Roger M. Russ

David Russo

James M. Rutten
Michael Sachs *
Charlene F. Sampson
Harley G. Sanders
Dixie Sanderson
Martha E. Sanford
Ronald A. Sanford
Frank J. Santalucia
Bruce W. Santoni
Milton C. Sappe
Alan E. Sapperstein
Jacob Sapperstein
Marlene A. Sathre
Daniel B Satisky
Alex Schamroth
Oscar M. Schapiro
Norma S. Schapiro
Sandra Schapiro
Cindy S. Schechter

Morton B. Scherr
Stanley Scherr
Howard R. Schiff
Ronald E. Schindler
Charles Schmidt
George M. Schmidt
Jack Schneider
Kenneth Schneider
Edwin J. Schneider
Michael Schneyer
Herbert Schneyer
Stephen Schonfeld
Gerald Schonfeld
Cathie Schumaker
Robert Schumaker
Brian Schumer
Donald H. Schumer
Frederick Albert Schumm
Charles John Schutz
Arthur Schwartz
Wendy Klein-Schwartz
Milton Schwartz
Nathan Schwartz
Alfred Schwartzman
W. Herdman Schwatka, Jr.
Donna L. Scott
David I. Scott
Edward Sears

David J. Seff
Roger G. Seitz
John J. Selak
Harry H. Sellers
John Sentman

Joel M. Serin
Milda Sermuksnis
David Serpick
Henry C. Shade
Nannette Shapiro
Hope J. Shapiro
Harry H. Sharata
June H. Shaw
Donald A. Shaw
Samuel J. Sheller
Wesley N. Shelton
Philip Shermack
Douglas Sherwood
Irving Shochet
Michael Shoemaker
Joseph W. Shook
Carla Showacre
Ronald G. Showacre
Emanuel Shulman
Martin Siegel
Harold Siegel
Gerald A. Sievers
Jack M. Silberman
Irvin Silen

12

Karen M. Sillers
Sidney Silverman
Steven L. Silverman
Albert M. Silverman
Irvin I. Silverman
Morton I. Silverstein
Harry Simmons
Majorie Klein Simos
Isadore E. Singer
Henry D. Singman
Robert Sinker

Ina L. Sirkis
Michael J. Skiba
William Skinner
Bernard L. Sloane
Ralph A. Small
Marla B. Smelkinson
William H. Smith
John C. Smith

Orin S. Smith
Brother Joseph H. Smith
Stanley Smith

Royal Smith
William P. Smith
Garel E. Smith
Arnold Smolen
Robert E. Snyder
Norman Sober

Carol A. Sobon
Herbert M. Sohmer
Sylvan L. Sollod
Melvin J. Sollod
Ralph M. Sollod
Theodore J. Sophocleus
Irving Sowbell
Arthur N. Spano
Murray C. Spear
Edward D. Spearbeck
Charles E. Spigelmire
Thomas J. Sporney
Edward Staffa
Jeanie L. Stanley
Alvin Stark

Thomas P. Starken
I. Barry Statter
Kimnn Stefanye
Charles Steg

John Steighner
Norman Steinberg
Sherman Steinberg
Richard L. Steinhilber
Joseph M. Stevenson
Milton E. Stewart
George J. Stiffman
Jerome A. Stiffman
Peter Clemo tock

Alan Stoff

Martin Stogniew
Myer Stoler

Donald C. Stran
Deborah C. Strauch
John J. Strauch
David Strickland
Elise J. Sublett
Vaiyapuri Subramaniam
Henry Sugarman
Bernard A. Sulewski
Fred J. Sullivan
Howard S. Surell
Thomas J. Suter
FranksJ. Suto

H. Albert Svrneck, Jr.
Barbara S. Swanson
Joel S. Swartz
Irving E. Swartz
Brian Sweeny

Peter P. S. Tam
Charles Taylor
Gary Taylor

Ronald C. Telak
Laura G. Tepper
James L. TerBorg
Ernest Testerman
Henry W. Theis
Robert E. Thiess
James B. Thomas
Richard G. Thompson, Jr.
Vito Tinelli
Vitoslinelivgur.
Warren Tom

Sylvan Tompakov
Angelo C. Tompros
Stacy Torokhanian
Earl M. Towers, Jr.
Earl S. Trachtenbert
Long K. Tran
Thomas Trite

James W. Truitt, Jr.
Lisa Ann Truitt
David B. Tschiegg
Samuel Tucker
Norman J. Turner
Allan E. Turner
Diane T. Tyrance
Fred M. Updike
David M. Via
Dominic J. Vicino
Rosalind L. Vick
C.SPhilipsvolk
David Lee Vollmer
Angelo C. Voxakis
George C. Voxakis
Mishel H. Wagman
Herbert Wagner

THE MARYLAND PHARMACIST

Charles H. Wagner

Dennis Michael Wagner

Karl G. Wagner
Robert W. Walden
David W. Walker
Richard J. Walsh
James T. Walter
Keith Walters
Patricia A. Wanzer
John L. Ware
Nelson H. Warfield
Jerome B. Warren
Milton Watkowski
David Watson, Jr.
Milton Waxman
Arthur H. Wear
Arthur B. Webb
Janet L. Weatherly
JoAnn Wehnert
David M. Weiner
Phillip P. Weiner
William Weiner
Morton H. Weiner
Michael Weinstein
Samuel Weisbecker
Mark D. Weisman
Frederick Wendte

LeRoy D. Werley, Jr.

Samuel Wertheimer
Frank J. Wesolowski
Teresa Wheelous

Alfred J. White, Jr.
Julia Merchlinsky White
Jacqueline White
Bernard N. White
Diane M. White
Reese E. Whitesell
Reese E. Whitesell
Emil Joseph Wiatrak
Maurice Wiener
Harry J. Wiest
Harry R. Wille
Bruce A. Williams
Charles Williams
Thomas G. Williams
Richard J. Williamson
Dalton J. Williamson
Diane K. Wills
Terry F. Wills
Henry Wineglass
Solomon Winn
Rudolph Winternitz
Gary Wirth

Thomas H. Wiser
Philip R. Wisner
Eddie Wolfe

Wanda K. Wolfe
Sandra C. Woronow
Barbara A. Woznicki
Douglas D. Wright

H. Boyd. Wylie
Beverly J. Yachmetz

Stanley J. Yaffe
Ellen H. Yankellow
Deborah Yaplee
Diana M. Yingling
Amanda M. Yoo
Irving Yospa

Linda Young

Donald Young

Jonas J. Yousem
Sidney M. Zalevsky
Lane P. Zangwill
Robert B. Zaretsky
Clifford Zarow
Joseph F. Zarych
Michael Zawisza
Max M. Zervitz
Gervis B. Ziegler

William L. Zimmerman

Paul Zucker
James J. Zulty

MARYLAND
PHARMACEUTICAL
ASSOCIATION

Dr. Arthur S. Flemming, president of the National Council on Aging and former secretary of Health, Education
and Welfare under Presidents Eisenhower and Kennedy, has been named advisory board chairman of The Center
for the Study of Pharmacy and Therapeutics in the Elderly established recently by the School of Pharmacy of the
University of Maryland at Baltimore. Shown here at the time of the announcement are: (left to right) Chancellor
Albert Farmer, Arthur S. Flemming, Dean William Kinnard Jr., and Center Director Peter P. Lamy.

DECEMBER, 1982 13

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stocked magazine department.

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should be yours because turnover is the name of your game and nothing you sell turns over
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And if you do have a magazine department, chances are your operation has Outgrown it
and it should be expanded.

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18 THE MARYLAND PHARMACIST

£.

gaggia i i
E . Pi

ri }
m2

Rick Smith, representing the Eli Lilly Company, presents MPhA
President Milton Sappe (right) with a special award on the oc-
casion of the Association's Centennial Founding Day.

Maryland Pharmaceutic
ASSOCIATION

& &

The press was invited to cover the seminar so that the public
might have a better understanding of the factors involved with
the rising cost of prescription drugs. Baltimore Channel 13 re-
porter Lisa Champo interviewed program participants.

This page donated by
District-Paramount
Photo Service.

DISTRICT PHOTO INC

10501 Rhode Island Avenue
Beitsville, Maryland 20705
In Washington, 937-5300
In Baltimore, 792-7740

DECEMBER, 1982

The Fall Regional Meeting held on October 17 at the new School
of Pharmacy Building featured a panel discussion on the rising
cost of prescription drugs and its impact on the health care de-
livery system. Participating were; (left to right) Stanton Brown,
Speaker of the House; Jay Rodgers, PMA Director of Marketing
Analysis; Marion Friedman, representing the Medical Society;
Paul Freiman, representing Pharmacy; and Stuart Baltimore,
BC/BS Director of Pharmacy Programs.

A milestone in Maryland Pharmacy occurred on October 17, 1982
when Dean William J. Kinnard, Jr. presided over the dedication
of the new School of Pharmacy located at 20 N. Pine Street in
Baltimore. Nearly 1000 persons toured the building following
dedication ceremonies and a block party.

Pictures courtesy Abe Bloom — District Photo

19

What You Should Know About
Commercial Armed Robbery

INTRODUCTION

Armed robbery is a dangerous crime that is on the
increase in Maryland and throughout the nation.

It is defined as the unlawful taking of property from
someone by using force or the threat of violence.

This booklet is designed to help retail managers and
employees cope with this serious crime threat.

e It stresses what you can do before you are vic-
timized to help prevent a robbery.

e It explains how the safety of customers and
employees can be maintained during a robbery.

e And it details the steps you can take before, dur-
ing and after a robbery to assist in the apprehen-
sion of the suspect.

By adopting common-sense security measures and
by training your employees, you can reduce the chance
that you will be robbed. And you'll increase safety in
the event you are.

BEFORE: PREVENTION

A total security program is the best way to prevent
armed robbery. Some of the following recommenda-
tions may not be possible in certain businesses. But the
more of them you follow, the greater security image you
will present. The stronger that security image is, the less
likely the robber is to select your place as a target.

Visibility

Good visibility is important for two reasons. First, it
allows employees to keep an eye out for any suspicious
persons who may be lingering either outside or inside
your business. And it increases the possibility that
someone outside will observe a robbery if it does hap-
pen. Robbers don’t like to be observed. So good visibil-
ity is a vital part of your prevention program.

Your front doors and windows should be kept clear
of signs and posters to allow good, two-way visibility at
your cash register area. Employees should be able to
see Out in order to spot suspicious persons who may be
casing your place. And passers-by should be able to
look in at your cash register area.

If you must post signs, place them to the side of the
store’s windows and either high enough or low enough
to retain visibility.

The outside of your business and the parking lot
should have enough lighting to provide visibility at
night.

20

Interior lighting also should provide good visibility
throughout your business.

The check-out stand and cash register should be lo-
cated in a central position where it is clearly visible to
observers outside.

Counters should be kept low enough so that
employees can see customers throughout the business.
If it’s not possible to reduce the height of present
shelves, you can at least stock only small merchandise
items on the top shelf.

Special display racks and carousels should be posi-
tioned in sucha way that they do not obscure visibility.

Special mirrors can be positioned in corners or other
strategic spots to help employees monitor the entire
business.

These suggestions will help prevent shoplifting,
also!

Cash Control

Perhaps the strongest deterrent is to practice and
advertise a cash-control policy. By keeping the lowest
possible amount of cash on hand and letting everyone
know it, you can reduce the attractiveness of your busi-
ness as a robbery target.

Experience has shown that businesses can readily
adjust to operating with less cash once a control policy
is instituted.

You should adopt a cash limit of, for example, $50.
If a customer offers a large bill, the clerk will politely
ask if he/she has anything smaller. Some stores, espe-
cially smaller ones, politely advise customers that they
can’t break a $20 bill (or anything larger than a $20) fora
minor purchase, like a pack of cigarettes.

Employees then should be trained to check regularly
for cash over that limit. Extra cash, especially large
bills, should be placed in a safe, preferably a “‘drop
safe,’ or a locked money chest.

Such a chest does not have to be burglary resistant
since its purpose is to discourage the robber. It can be
as simple as a steel box, bolted to a counter or wall, and
locked.

Most law enforcement authorities recommend a safe
which the clerk cannot open alone or one which re-
quires two keys. That fact should be posted near the
entrance or some other conspicuous place and on the
safe itself.

If it is not possible to have a safe, don’t place extra,
large bills under the cash register till. Most robbers

THE MARYLAND PHARMACIST

know about that. If you don’t have a safe, figure out the
least obvious alternate place to hide your extra cash
until it’s time to go to the bank.

These cash-control measures don’t help unless you
post the fact that you practice them. Post a sign, such as
**$50 Maximum Cash in Register,’’ in a prominent place
near your check-out stand and business entrance.

It’s also a good idea to post a sign near the register,
such as ‘‘We Appreciate Exact Change.”’

Banking

As an extension of a cash-control policy, you should
deposit your money as often as is practical. This should
never be less than daily and, preferably, should be more
often.

Before you leave for the bank:

@ Jot down the serial numbers of several of the
larger bills as evidence in the event you are robbed.

e Look outside to see if any suspicious persons are
lingering. If they are, call law enforcement and
request a patrol check.

You should vary your banking routine. Carry your
cash in a variety of ways, such as in a lunch sack, at-
taché case, flight bag, pocket, etc. If you leave with a
bank money bag, you could be inviting a robbery en
route.

Try to bank at different times of the day so that you
don’t set a pattern for someone who may be casing your
place. It’s also advisable to vary your route to the bank
for the same reason. But always go to the bank directly,
without making any other stops.

Alarms

Another deterrent factor that will contribute to your
total security image is to install an alarm and post the
fact that you have one.

Alarms are available in a variety of price ranges. In
choosing an alarm, it’s best to get bids from three or
more reputable firms, if possible.

The most important factor in alarm selection is the
safety with which it can be activated. An alarm which
requires a clerk to push a button, for example, is ex-

DECEMBER, 1982

tremely difficult to use without arousing the robber’s
suspicion.

Perhaps one of the safest types of alarm is called a
‘bill trap’ or “‘money clip.’’ This type of alarm is in-
stalled in one slot of your cash drawer. The last bill in
the slot serves as an insulator, but when it is removed in
a robbery, the metal parts touch, activating the alarm. If
you use a “‘money clip’’ alarm, it should be installed in
the slot of one of the larger denominations—for exam-
ple, the $10.00 slot.

Many law enforcement agencies have procedures
for alarm verification and robbery response. It’s advis-
able to find out what they are so that you'll know what
to expect in the event of a robbery.

Suspicious Persons

All employees should be trained to be alert for sus-
picious persons. Remember, such observation will be
more effective if you have good visibility both outside
and inside.

Outside, parked cars and telephone booths are
among favorite observation posts for casing a business.

Inside, clerks should be alert for ‘‘customers’’ who
seem to be loitering or glancing around the store while
appearing to shop or browse through a magazine.

Robbers don’t like to be noticed or to have personal
interaction. Therefore, it’s a good idea for an employee
to greet all entering customers politely, look them in the
eye and ask if he/she can be of some help.

If a clerk spots a suspicious person either outside or
inside, call law enforcement and ask for a patrol check.

For this reason, post your law enforcement agency's
emergency telephone number on or near all of the
phones in your business.

If you have a surveillance camera and the suspicious
person is inside, it’s a good idea to activate the camera
for several frames. Such photos would be valuable evi-
dence should the person return later for a robbery.
(Your crime prevention officer can assist you in ob-
taining more information on surveillance cameras.)

Check References

A surprising number of armed robberies involve
former employees. For that reason, authorities recom-
mend that you screen applicants as carefully as possible
before offering a job. Ask for and follow up on character

ZA

references and, especially, former employers. A few
phone calls may save you a variety of problems later on.

It’s also a good idea to invest in an inexpensive cam-
era. Take a snapshot of each new employee and keep it
in the personnel file. (If you have an employee bulletin
board, you can post the photo and an introductory wel-
coming note for a few days.)

A photo could help law enforcement identify a past
employee who has come back to rob you. And the
knowledge that such a picture exists just might discour-
age the potential robber.

Opening/Closing Times

Opening and closing times are especially vulnerable
times for robberies. If at all possible, have two persons
on hand at both times.

At opening time, one person should enter the busi-
ness to check to see if it has been disturbed overnight. A
second person should wait in an inconspicuous location
outside the business until receiving a pre-arranged “‘all
clear’? signal from the person inside.

Before closing, check the office, back rooms, rest
rooms and other areas to make sure no one is hiding
there.

Side/Back Doors

If possible, side or back doors should be kept locked
at all times to prevent a potential robber from entering
undetected. Ask employees to use the main entrance to
avoid the chance that a back door will be left unlocked
accidentally.

Storage Rooms

Robbers sometimes lock employees in storage
rooms. Therefore, it is advisable to install a lock that
can be opened from the inside and to keep an extra key
there.

For the same reason, if you have an alarm, consider
installing a button in the back room.

Weapons

It may occur to you to keep a weapon at the busi-
ness. Virtually all authorities strongly recommend
against it. The chances of injury ... or worse... are
just too great.

Credibility

Don’t be tempted to use phony signs or equipment.
The use of a phony surveillance camera, for example,
can destroy the credibility of all of your other security
precautions.

BEFORE: IDENTIFICATION
Here are two simple steps you can take at no cost to
help in the apprehension and conviction of a suspect.

D WD.

Bait Money

Take several dollar bills and write down their serial
numbers. Keep the record in a safe place. Then place
these recorded bills at the bottom of a till section hold-
ing one of the larger denominations—for example,
under the $10 bills.

Don’t use the bait money for normal transactions.
But, of course, it should be given to a robber along with
other money. It’s a good practice to change the bait
money from time to time.

Your record of the serial numbers could help track
the robber and will be proof that the money was stolen
from you.

Height Markings

Place markers at the main entrance to help em-
ployees to gauge the height of a robber as he leaves
your business.

All you'll need is a few pieces of one-inch wide col-
ored tape. Place tape in strips about an inch high at the
5’, 5'6” and 6’ heights. Vary the color of the middle tape;
so that there is no confusion.

DURING: SAFETY

Even with a strong security program, there is some
chance that a robbery will occur.

Robbery is a potentially explosive confrontation.
Yet most robberies take less than two or three minutes.
It’s imperative that everyone involved in a retail opera-
tion be taught how to react in that short period of time in
a way that will promote the safety of employees and
customers.

Your employee training should include involving
personnel in a ‘‘mock’”’ robbery.

The Employee

The employee should be trained to act according to
these time-tested recommendations:

e Be as polite and accommodating as possible
under these trying circumstances.

e@ Don't appear to be stalling. Convey by actions
and/or words that you will cooperate.

THE MARYLAND PHARMACIST

@ Do exactly what the robber asks. If he asks for
tens and twenties, for example, give him those
only.

e Tell him in advance if you need to make any
move, especially one he doesn’t expect. If he
wants the money in a bag and you have to reach
below to get one, tell him what you are going to do.

e Do not try to use an alarm, especially of the
hand- or foot-activated type, unless you can do
so safely without any obvious movement which
might cause the robber to react in panic.

The Robber

The robber is likely to be a young male. In many
cases, he will be armed with a deadly weapon.

The robber will be a bundle of nerves. He is likely to
react even more aggressively to any act which comes as
a surprise or appears threatening.

All law enforcement experts agree: This is no time
for impulsive heroics. Your percentages are not good.
The stakes are not worth serious injury or death. Money
can be replaced, a life cannot!

Once a robbery begins, there is only one mission:
maintain safety until the robber leaves.

DURING: IDENTIFICATION

While the primary concern should be to follow these
safety suggestions, employees also should be aware of
what they can do to help identify the robber.

Demand Note

Any note which the robber might give could be valu-
able for handwriting and fingerprint evidence. Try to
slide any note out of the robber’s reach in a casual way,
handling it as little as possible.

Suspect ID

Try to observe the robber in as normal a way as
possible, without staring obviously.

The more you can remember, the more helpful it will
be to law enforcement. The most important points:
color of hair, eyes and skin . . . facial features .. . ap-
proximate age, height and build . . . any unusual mark-
ings (scars, tattoos, etc.) . .. mannerisms or speech pe-
culiarities or accents... jewelry ... clothing.

Physical features and mannerisms are more impor-
tant than clothing because the latter can be changed or
discarded, especially caps or jackets. Jewelry is less
likely to be discarded.

A suspect identity chart appears on page 24. You
can make photocopies of that chart and keep them near
the check-out stand for later reference.

Weapon ID

Although information about weapons is helpful to
law enforcement, it is not practical to train employees in
technical detail.

DECEMBER, 1982

However, anything they can remember about the
weapons would be useful. Also try to note in which
hand the robber is holding the weapon.

The most prevalent weapons are handguns. There
are two basic types:

Revolver: The distinguishing feature is a cylinder in
the middle which revolves to put the bullets into posi-
tion.

Automatic: These are flat-sided—no cylinder. The
bullet clip is in the grip, where you can’t see it.

Rifles and shotguns also are used in robberies. The
shorter, sawed-off variety of shotgun often is used.

If any type of rifle or shotgun is used, it is most
important to tell the police so that they can make safety
considerations in pursuit and apprehension.

Bear in mind that just because you can’t see a
weapon doesn’t mean that the robber doesn’t have one
concealed.

Departure

As the robber is leaving, continue to obey his direc-
tions exactly until you know he is out of the business.
Do not try to follow him.

AGAIN, IT CANNOT BE EMPHASIZED
ENOUGH TO COOPERATE AT ALL TIMES
WITH THE ROBBER. YOUR PRIMARY
CONCERN IS TO BECOME A SUCCESS-
FUL VICTIM—ONE WHO HAS GOTTEN
THROUGH THE SITUATION’ UN-
HARMED.

AFTER: EVIDENCE AND IDENTIFICATION

1. Once the robber is outside, try to watch through
the window. Try to note the type of get-away vehicle,
whether or not there were any accomplices and the di-
rection.of escape. If it is possible to see the vehicle’s
license number, write it down. (Once again, the visibil-
ity factor is important.) Close the business and lock the
door if at all possible.

2. Then call law enforcement immediately, using
the emergency number posted by the telephone. Do this
even if you already have activated an alarm.

State your name, address and telephone number and
what happened. Stay on the line until they tell you to
hang up.

3. Do not discuss details of the robbery with fellow
employees, witnesses or anyone else. Ask any witness-
es to stay until police arrive. While they wait, encour-
age them to write down what they remember. If they
can’t stay, get their names and addresses so police can
reach them later.

4. Next, try to protect any fingerprints or other evi-
dence. Use a box, bag or anything else handy to cover
or block off any merchandise, counter area or door han-
dle which the robber may have touched. Don’t touch
those things yourself.

oS

SUSPECT ID CHART

(Use this page to make photo copies for your employees

RACE HEIGHT
—S

te

)
WEIGHT

HAT
(COLOR Y BE}

TATTOOS
SCARS/MARKS
COMPLEXION

BAIT MONEY SERIAL NUMBER

AUTOMOBILE DESCRIPTION
(LICENSE NUMBER, MAKE, COLOR)

STAY ON THE PHONE!

Clip and post

5. Try to recall as much as you can about the rob-
ber’s appearance, speech and mannerisms. It’s best to
make notes on these points as soon as possible. Inves-
tigating officers will know what to ask you. Use your
notes to help answer their questions as fully as possible.

6. Obtain the recorded serial numbers of your bait
money and give to the officer.

Let the police answer any inquiries from the news
media. do not discuss the amount of money taken with
anyone except law enforcement. Ask investigating of-
ficers to keep the amount of money confidential.

NOW IT’S UP TO YOU!

This book is a part of Maryland’s State-wide crime
prevention effort known as Maryland crime Watch.
For additional information, please contact:

Maryland Crime Watch
Suite 700, One Investment Place
Towson, Maryland 21204

Phone: )301) 321-3636

Get Ready for
Poison Week

This year’s Maryland Poison Prevention Week—83
(March 20—26, 1983) will focus on the ‘‘ warning signal’’
words used on product labels. A poster and handout
explaining what these signal words are and what they
mean in terms of toxicity is currently being developed
by the Maryland Poison Center for use in pharmacy,
hospital, and Health Fair-83 sites. A packet of materials
for use in MPPW-83 will be available at minimal charge
for postage and handling in mid-February. Additional
materials will be available at cost.

Again this year the Maryland Poison Center urges
pharmacists, especially preceptors, to actively promote
MPPW-83 poison prevention activities in any way—
poster contests, displays, presentations to the commu-
nity, etc. Syrup of ipecac will again be stressed as the
major medicine to have in case of a poisoning. Copies of
last year’s poster on Syrup of ipecac ‘‘Mr. Yuk saves
lives ... Syrup of ipecac can too’’ are still available
from the center.

If you are interested in participating in Maryland
Poison Prevention Week—83, please contact Jacquie
Lucy, MPC education coordinator, at (301) 528-7184.
An order form and sample of the handout should appear
in the January issue of the Maryland Pharmacist.

DECEMBER, 1982

ET VE tS:

Dear Mr. Banta:

I very much appreciate the old prescription and
apothecary jar which you so thoughtfully presented to
me on September 28, 1982. I was pleased to proclaim
‘‘Maryland Pharmaceutical Association Founding Day”’
and am glad that you were able to join me for the proc-
lamation ceremony.

You have my best wishes.

Sincerely,
Harry Hughes
Governor

Dear Dave Banta:

I sure miss you wonderful men there. Convey my
best wishes to them and hopefully I may get back there,
I love it so very much.

I read over all the materials you mail me from cover
to cover and keep my Md. license current with much
pride.

Say Hello to the Eastern Shore group—a wonderful
great group.

Our Love and Best Wishes to all of you.

Sincerely
Vince Gattone

Gentlemen,
Would it be possible to put a notice
in one of the publications that I
am in need of Glysenned Tablets—any amount.

Thank you,
ARCADE PHARMACY

5500 HARFORD RD.
BALTIMORE, MD 21214

P|

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Is your professional investment sufficient?
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Treasury regulation 1.162-5 permits an
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Please rush me the following items
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484-7000

ABSTRACTS

Excerpted from PHARMACEUTICAL TRENDS, published by the
St. Louis College of Pharmacy; Byron A. Barnes, Ph.D., Editor
and Leonard L. Naeger, Ph.D., Associate Editor

SALMONELLA:

Salmonella is one of the most common pathogens
found in contaminated food. When outbreaks occur, in-
vestigators try to find a common source of the poisoning
in order to prevent further problems. Recent outbreaks
in Ohio, Michigan, Georgia, and Alabama have been
found to be associated with contaminated marijuana.
The organism isolated from the plant material contains
two low molecular weight plasmids not found in other
strains of Salmonella. N Engl J Med, Vol. 306, #21, p.
1249, 1982.

HYDRALAZINE:

Patient compliance is lessened as the number of
doses required per day increases. Efforts have been
made to study drugs which require frequent administra-
tion to see if larger doses might be given less frequently
without sacrificing efficacy or increasing toxicity.
Hypertensive patients receiving hydralazine have been
examined and investigators have concluded that ade-
quate blood pressure control can be achieved if the drug
is taken twice daily. Br Med J, Vol. 284, #6329, p. 1602,
1982.

ORAL CONTRACEPTIVES:

The incidence of ovarian cancer in women was
studied in approximately 136 patients. Results of the
study indicate that women taking combination oral
contraceptives experience fewer neoplastic growths
than do those not taking the medication. Some re-
searchers feel these preparations may help protect
against the development of ovarian cancer. J Am Med
Assoc, Vol. 247, #23, p. 3210, 1982.

INDOMETHACIN-MORPHINE COMBINATION:

A prospective randomized trial was undertaken to
assess the combination of indomethacin (Indocin) and
morphine to relieve discomfort in post-surgical patients.
Patients who received the anti-inflammatory agent re-
quired fewer doses of the narcotic than did those not
receiving the indomethacin. It seems logical to use
anti-inflammatory agents in conjunction with narcotics
in post-surgical patients. Lancet, Vol. I, #8290, p. 115,
1982.

HOT TUBS:

Occasionally an outbreak of cutaneous Pseudomo-
nas aeruginosa occurs in people who have shared hot
tubs. The eruptions generally occur in areas covered
by the swimming suit and appear within 8 to 48 hours
after exposure. This can be prevented by keeping the
pH of the water between 7.2 and 7.4 and by keeping
chlorine levels between 0.4 and 1.0 ppm. Am J Dis
Child, p. 553, June, 1982.

28

TRAVELERS DIARRHEA:

Approximately half of the Americans visiting foreign
countries will experience diarrhea which can be un-
comfortable, debilitating, and sometimes very danger-
ous. Since Escherichia coli toxin is the most common
cause of this condition, a vaccine is being readied for
clinical trials which may be useful in preventing the de-
velopment of these symptoms. The vaccine will act to
reduce the ability of the organism to adhere to the cells
of the intestinal lining and thus they will pass harmlessly
from the body without causing toxicity. J Am Med
ASSOC,» VOL.2AT. #24, D. 029) 982.

INSULIN PUMPS:

After several years of refinements, insulin pumps
are now of such size that they can be implanted into the
left subclavian fossa. Patients with insulin dependent
diabetes mellitus (Type II hyperglycemia) achieve good
blood glucose control with those infusion pumps and
thus investigators feel these devices can be used with
confidence in patients requiring insulin to control their
symptoms. N Engl J Med, Vol. 307, #5, p. 265, 1982.

COLONIC IRRIGATION:

Irrigation of the colon using a series of enemas in a
short time frame has been used by some practitioners of
homeopathy, naturopathy, chiropractic, and nutritional
therapy. At one time, this was considered a harmless
procedure, but deaths due to electrolyte disturbances,
bowel perforation and necrosis and toxic colitis have
occurred following the procedure. A recent outbreak of
amebiasis was traced to a contaminated apparatus used
for this procedure. N Engl J Med, Vol. 307, #6, p. 339,
1982.

ASPIRIN:

Studies using low dose aspirin seem to show the
antiaggregation effect of the salicylate can be produced
at very los dosing regimens. Higher doses interfere with
prostaglandin synthesis in other parts of the body and
thus the effect is lessened. The dose used in this study
was 0.45 mg/kg/day which is equivalent to approxi-
mately 30 mg/day for the average adult. J Clin Invest,
Vol. 69, #6, p. 1366, 1982.

FUROSEMIDE:

Thiazide diuretics cause calcium retention while
loop diuretics cause calcium to be lost. Studies suggest
that calcium absorption in the loop of Henle is inhibited
by the loop diuretic and thus calcium excretion is in-
creased. J Pharmacol Exp Ther, Vol. 221, #3, p. 815,
1982.

THE MARYLAND PHARMACIST

ANTIDEPRESSANTS:

Generally the combination of a monoamine oxidase
inhibitor and a tricyclic antidepressant is not recom-
mended, but a group in Great Britain have used the
combination to prevent the ‘‘cheese’’ reaction seen
when some people taking monoamine oxidase inhibitors
alone ingest the dairy product. Cheese contains
tyramine, an indirect acting adrenergic agent which can
increase blood pressure, cause headaches, and induce a
hypertensive crisis. Since tricyclic antidepressants pre-
vent neuronal uptake of norepinephrine, and since
tyramine and norepinephrine are structurally similar,
amitriptyline (Elavil) was administered along with the
monoamine oxidase inhibitor to patients who experi-
enced the cheese reaction while taking the enzyme in-
hibitor alone. These patients tolerated the cheese inges-
tion with the combination therapy. Since monoamine
oxidase inhibitors do allow for the accumulation of
tyramine in the plasma, ingestion of foods which con-
tain the amine should be avoided even in patients re-
ceiving combination therapy. Lancet, Vol. II, #8291, p.
183, 1982.

MORPHINE:

Post-surgical patients were given standard doses of
morphine (10 mg if they weighed less than 70 Kg and 15
mg if they weighed more) intramuscularly and the re-
sults of this injection compared to those received in
patients who had taken morphine orally in a sustained
release tablet form. The oral form was administered in
doses which were exactly double those used via the
injectable route. Oral formulations produced satisfac-
tory pain relief when compared to the injections and
therefore this may be a way to avoid injecting drugs if
the patient can tolerate oral medication. Br Med J, Vol.
285, #6335, p. 92, 1982.

PLATELET ACTIVITY:

Platelet metabolism had been intensively investi-
gated over the past several years and a substance called
calmodulin seems to play a major role in the activation
of platelet enzymatic activity. Calmodulin probably
mediates calcium control of several biochemical pro-
cesses in the platelet and thus deserves further study.
Another substance found to play a role in platelet activ-
ity is gelsolin. J Clin Invest, Vol. 69, #6, p. 1348, p.
1384, 1982.

ALCOHOL AND CONGESTIVE HEART FAILURE:
Patients with congestive heart failure were given
various doses of ethanol in the form of vodka and their
cardiac function monitored closely. No changes were
seen in cardiac function or performance and thus occa-
sional consumption of moderate amounts of alcohol can
safely be tolerated in patients treated for congestive
heart failure. Ann Intern Med, Vol. 97 #2, p. 171, 1982.

DECEMBER, 1982

CALCIUM:

Patients with hypertension are noted to have several
types of metabolic disturbances, including hypocal-
cemia. A study of normal and hypertensive patients has
indicated that the serum ionized calcium concentration
in hypertensive patients is lower than that found in
normotensive volunteers. Further investigation will try
to determine if calcium has a role in the production of
essential hypertension. N Engl J Med, Vol. 307, #4, p.
226, 1982.

URIC ACID AND DIABETES:

A prospective study of diabetes in 10,000 men over
the age of 40 years has yielded some unexpected results.
It seems that those men with a predisposition for diabe-
tes mellitus have elevated levels of plasma uric acid
when compared to normal controls. No explanation for
the rise is known but it may be a useful tool in screening
patients who may have a greater likelihood of develop-
ing diabetes mellitus. Lancet, Vol. I, #8292, p. 240,
1982.

MINOXOLONE:

A new water-soluble steroidal anesthetic has been
used intravenously for periods as long as three hours.
The distribution of the drug is rapid, and the half-life is
short. Minoxolone may be suitable for use by intrave-
nous infusion. Support for investigation of this drug is
being supplied by Glaxo Canada Limited. J Clin Phar-
TNUGOLMN O22 DLO. al ool.

THROMBOXANE:

Thromboxane A-2 is a potent endogenous platelet
aggregator which is decomposed to form thromboxane
B-2, an inactive metabolite. Patients dying with septic
shock have been found to have ten times more throm-
boxane B-2 in their plasma than do patients who survive
this potentially fatal condition or in normal volunteers.
Investigators are trying to determine if thromboxane
contributes to the respiratory distress syndrome and
disseminated intravascular coagulation which is as-
sociated with severe sepsis. Lancet, Vol. Il, #8291, p.
174, 1982.

PERSONALITY CHANGES:

The type A personality is one characterized by hard
working, aggressive behavior. This group of people
have a high incidence of hypertension and coronary
heart disease and thus are frequently treated with beta-
adrenergic blocking agents. Physicians have found that
after taking these drugs for a period of time there is a
tendency for the person to experience a personality
change toward the type B personality, a less aggressive
type. Beta-adrenergic blocking agents cross the blood
brain barrier and thus may be responsible for this per-
sonality shift. J Am Med Assoc, Vol. 247, #20, p. 2759,
1982.

29

UMS TM WU)

MM WMA

bi oy,
So ™

oa

WH CUS |

Research Roulette

In 1981, the cost of developing a new chemical entity was $77 million. Yet, three out of
four new chemical entities marketed never recapture their R & D investment.

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health care costs as compared with 16 percent 40 years ago.

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Classified ads are a complimentary
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calendar —Z

January 23—30 Antigua MPhA Trip—limited space
available $699 per person

Feb. 13 BMPA Dinner Dance—get your table to-
gether soon—see Charles Spigelmire for ar-
rangements and Man of the Year Tickets—be a
winner

March 13 *‘Communication and the Elderly’ Center
for Aging MPhA Seminar

March 27 *‘Arthritis’°-—CECC Seminar

June 18—30 MSHP Annual Seminar—Atlantic City

June 26-30 MPhA CONVENTION IN OCEAN
CIT Y—-year 101

Every Sunday Morning at 6:30 a.m. on WCAO-AM and 8:00 a.m. on
WXYZ-FM, listen to Philip Weiner broadcast the Pharmacy Public
Relations Program ‘Your Best Neighbor,” the oldest continuous
public service show in Baltimore.

DECEMBER, 1982

PERSONAL MEDICATION RECORD

Prepared by ELDER-ED
University of Maryland School of Pharmacy
636 W. Lombard St. Baltimore, Md. 21201

With a grant from Parke-Davis
Division of Warner-Lambert Company

This Medication Record is available at no charge from either the
Association office or the Elder-Ed Program for distribution to
your patients. Call and order yours now.

We at SELBY DRUG COMPANY
attribute our rapid growth and success
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For information on our Full Line pro-

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