the georgia pharmacy journal: february 2009

VIP (Very Involved Pharmacist) DayFebruary 18, 2009

The Official Publication of the Georgia Pharmacy Association February 2009

Volume 31, Number 2 www.gpha.org

The Georgia Pharmacy Journal February 20092

Look what’s NEW in 2009...Reduced Rates

Prescription Drug CoverageDental and Orthodontic Benefits

Guaranteed Issue Term Life Insurance... up to $150,000with no underwriting requirements

Call or e-mail TODAY to schedule a time to discuss your health insurance needs.

Trevor Miller – Director of Insurance Services404.419.8107 or e-mail at [email protected]

NEW PLANS – BETTER RATES – MORE BENEFITS in 2009


F E A T U R E A R T I C L E S

12 Get “Fresh” for Your Valentine:10 Ways to Keep Your Breath Fresh17 GPhA’s Legislative Update Article &

Event Information20 The 13th Annual Southeastern PRN Conference

22 Georgia Pharmacy School News

24 Pharmacy Time Capsule

C O L U M N S

4 President’s Message

6 Editorial

For an uptodate calendarof events, log ontowww.gpha.org.

16GPhA Convention Registration

InformationJune 2024, 2009

Ponte Vedra Beach, FLSawgrass Golf Resort and Spa, A Marriott Resort

Departments10 New Members11 GPhA Members in the News13 Call for Award Nominations14 GPhF Information25 Journal CE30 GPhA Board of Directors

Advertisers2 The Insurance Trust2 Meadowbrook® Insurance Group4 Middle Georgia Relief Services5 PQC7 Toliver & Gainer7 MTM Toolkit8 Pharmacists Mutual Companies9 AIP Meeting Annoucement17 GoodSense21 Michael T. Tarrant24 GPhA Career Center31 PACE Alliance32 The Insurance Trust

P R E S I D E N T ’ S M E S S A G E

For the Love of Our Profession


February is the month of love and the need for love ofour profession is no exception. It becomes moreimportant every year for us to express the love that we

have for our profession. Every day that we practice pharmacy,we have the opportunity to demonstrate our love for ourprofession by reaching out to our patients and making adifference in their lives — from taking the time to wrap ourarms around an elderly patient letting them know that we trulycare about them to interacting with a young child thus creatinga lasting impression in that child’s mind of what it was like to goto the pharmacy.

Our love for our profession can also be demonstrated by beinginvolved in the political process and enhancing theopportunities that we have in our practice settings. Thelegislative session began in the state Capitol on January 12. Wemust remember that as constituents of our elected officials, wedo have a voice in the decisions that are made about ourprofession. When you receive a call from GPhA tocommunicate with your elected official, it is important for youto respond quickly and communicate your concerns and howyou want your legislator to vote.

Representation at the Capitol is critical to the success ofpharmacy as a profession. GPhA’s Director of GovernmentalAffairs is our daily representation at the Capitol. He can only be

effective if we are committed enough to our profession to speakas one large strong voice. We can help him achieve the goals ofpharmacy by telling our friends and colleagues to join theassociation. While our numbers are stong it is our goal to have3,000 members by the end of the fiscal year. You can help usachieve this goal by asking your friends and colleagues who arenot members to join, or asking your friends and colleagues whowere once members to rejoin. If you are not sure who is or isnot a member call Kelly J. McLendon, GPhA’s Director ofPublic Affairs at 404.419.8116 or email her [email protected]. During these times of economic fearand trepidation we must love our profession enough to help itgrow and thrive, or we will all suffer.

Robert Bowles, Jr. , R.Ph., CDM, CFtsGPhA President

Middle Georgia PharmacyRelief Services

Pharmacy Staffing for:• Chain & Independent Pharmacy• Clinic & Hospital Pharmacy• Specialty & Long Term Care Pharmacy• Over 30 years Rx Experience

Call 478-552-7220 AL Curry, R.Ph.

Email: [email protected]

Tennille, GA 31089

www.middlegeorgiapharmacyreliefservices.com

E X E C U T I V E V I C E P R E S I D E N T ’ S E D I T O R I A L

Jim BracewellExecutive Vice President / CEO

Is Georgia Ready for a Pharmacist in theState Senate?

6The Georgia Pharmacy Journal February 2009

Last week our own Georgia Pharmacy Associationmember, state Representative Buddy Carter, R.Ph.,of Pooler, Georgia, announced his candidacy for state

Senate District 01. Current Senator Eric Johnson will not beseeking re-election to the Georgia Senate in lieu of a run forLt. Governor.

Representative Carter was ready to seize this opportunity toserve in the senate and the Georgia Pharmacy Association isready to seize this opportunity to put a pharmacist in theGeorgia Senate.

Do we really want to plan to put a pharmacist in the statesenate in 2010 or do we just want to talk about how good itwould be for pharmacy if it happened? The best way topredict the future is to create the future. Join your pharmacyfriends today and let’s work our plan to put Buddy Carter inthe Senate in this next election.

What can you do at this early stage of a campaign for anelection on 2010? Today you can begin a real list of family, friends, businesscolleagues, and college friends who may live or work inBryan, Chatham or Liberty Counties in Senate District 01.This action is a true value to this campaign. We need to getpeople on board early and committed before the othercandidates enter the field. This past national electiondemonstrated the value of communications via the internet.How many of your list have email addresses? If you wouldcontact your list and ask permission for the campaign to sendthe updates we could develop a solid base of support forBuddy Carter over the next several months. For those that donot personally know Buddy, they will become acquaintedwith his background, his experience and his desire to servethe people of this state.

How does “State Senator Earl “Buddy” Carter, R.Ph.”

in 2010 sound?


What else can you do if you do not live in SenateDistrict 01? Well in these tough economic times, you should plan afinancial budget to provide support for this campaign on amonthly basis. That way you do not have to wait for us tocome to you about a big fundraiser. The best way to eat anelephant is one bite at a time. The best way to finance yoursupport for is a monthly pledge to Friends of Buddy Carterfor Senate, P.O. Box 222, Pooler, GA, 31322. In respect tothe state ethics law, Buddy cannot accept contributions whilethe Legislature is in session so save your January, Februaryand March contributions and send them to him in April2009.

The pharmacists of Georgia came together to support OrenH. “Buddy” Harden, Jr., R.Ph. for the House successfullythis fall. We have tasted victory and it is sweet. It is timeGeorgia Pharmacy Association — go for the prize of a stateSenate seat! District 01 in 2010 is our opportunity. CarpeDiem – Seize the day for Pharmacy.

Lawyer and Pharmacist Leroy Toliver, Pharm.D., R.Ph., J.D.

• Professional Licensure

Disciplinary Proceedings

• Medicaid Recoupment Defense

• Challenges in Medicaid Audits

• OIG List Problems

• SCX or Other Audits

Leroy Toliver has been a Georgia Registered Pharmacist

for 34 years. He has been a practicing attorney for 25

years and has represented numerous pharmacists and

pharmacies in all types of cases. Collectively, he has

saved his clients millions of dollars.

Toliver and Gainer, LLP

942 Green Street, SW

Conyers, GA 30012-5310

[email protected]

770.929.3100


AIP Spring MeetingApril 25-26, 2009

Sea Palms Resort, St. Simons Island, GA

Please Fax Registration to 404.237.8435

• CE opportunities • AIP Business Meeting • Social and Cocktails with our Partners

Registration: (For Planning Purposes Please Fill Out and Return)

Member’s Name: __________________________Nickname (for badge): __________________________

GA R.Ph. License No:___________ Pharmacy Name: _________________________________________

Address: _____________________________________________________________________________

Phone:(____)____________ Fax:(____)_____________ E-mail Address: __________________________

Please circle the following: Academy Member? Yes No GPhA™ Member? Yes No

**If Spouse/Guest is attending please print his/her name: ______________________________________

Nickname (for badge): ___________________ Is the above guest a member of GPhA? Yes____ No ____

Georgia Pharmacy Association is accredited by the Accreditation Council for Pharmacy Education as a provider ofcontinuing pharmacy education.

Please call 1.800.841.6268 for reservations(Ask for the AIP room block)

Come relax in the lush oasis that is Sea Palms Resort. Take a walk under ancientlive oaks, where the ocean air mixes with a soft marsh breeze. Bike on the beach,play golf, tennis or just relax on your balcony overlooking the island's natural beauty.Sea Palms Resort offers the perfect setting for our AIP Spring Meeting.

Our spring meeting will offer continuing education, time to meet with our vendors,an AIP Business Session to discuss issues impacting independent pharmacy, time tonetwork with other AIP Pharmacies and catch up with old friends. Plan onattending and bring your family for a weekend to be remembered.

AIP has negotiated a special room rate of $139 (Deluxe) and special pricing on otheraccommodations (accommodation choices include hotel-style deluxe guest rooms,executive studios with kitchenette and fully furnished one to three bedroom suiteswith scenic sun deck or screened porch). To guarantee that you receive this specialrate and to ensure you get a room please make your reservation as soon as possible.

Sea Palms has more amenities than any other property on St. Simons Island and isjust minutes from the beach. With twenty seven holes of golf, three swimmingpools, three rubico clay tennis courts, a fitness center and sauna, sandpit volleyballcourt, bike rentals and horseshoes, the recreational opportunities are boundless.

We are very excited about this year’s AIP Spring Meeting. We will give you moredetails as the time nears. Make your plans now to attend.


Welcome to GPhA!The following is a list of new members who have joined Georgia’s premier

professional pharmacy association!David Anderson, ConyersHaley Anderson, SylvaniaCody Babcock, Martinez

Jessica Baker, Jacksonville, FLHeather Barnes, Jacksonville, FL

Scott Behrens, SavannahLinda Berger, Savannah

Samuel Norman Bird, R.Ph., MaconAngelica Bontilao, SavannahJeffery Callaway, Savannah

Carrie Chestnutt, Valley, ALDana Chiulli, GainesvilleBrian Cohen, Savannah

Rebecca Crunelle, SavannahBarrett Andrew Darley, Uvalda

John E. Davis, B.S., WaycrossDaniel De Arazoza, Savannah

Andrea Delapaz, SavannahPascale Desplaneque, Savannah

Nhu Nguyen Do, SavannahLinh Doan, Savannah

Heather Drazdowski, Warner RobinsSusan Fallahi, Savannah

Julie Ann Feltman, B.S., ChatsworthSidney L. Finn, Ph.D., Savannah

Shari Flynn, Kansas City, MOStephanie Fong, Chandler, AZ

Nicole Fowler, PoolerMatthew Fox, SavannahChasity George, Rincon

Roberto Godreau, HinesvilleChristina Gomez, Savannah

Donya Goodly, SavannahMalissa Harbin, Savannah

Kinsley Harrell, LilburnClaude Hartsock, B.S., R.Ph., Pendergrass

Jessica Helton, SavannahMaeve Hines, Savannah

Lauren Hogan, Morganton, NCJeffrey Hogg, Rincon

Adrianne Horton, ValdostaMatthew Allen Jacobs, C.Ph.T., Acworth

Phyllis Thompson Johnson, B.S., HazlehurstRachel June, Pace, FL

Anne H. Keaton, KennesawKelly Kennedy, Bloomingdale

Julya Khapun, AlpharettaThomas King, Savannah

Kimberly Kirby, Young HarrisAmanda Kragel, Savannah

Mitchell Lee, SavannahTrufa Lemma, Savannah

Stanley Roy Lewis, B.S., Houston, TXRyan Lezer, SavannahAily Liem, Savannah

Marilyn Luk, SavannahKim Ly, Savannah

Paul MacDowell, SavannahBrittani McLeod, Savannah

Betty Morris, Birmingham, ALMichelle Motl, Tampa, FL

Nhan Ngo, DuluthDuyvy Nguyen, SavannahThao Nguyen, Norcross

Marissa Nolan, ColumbusMagan Ogden, JesupEmi Onuki, SavannahEsther Park, Lilburn

Kelvin Park, SavannahKomal Patel, Byron

Stephanie Peanasky, SavannahJeannine Powel, SavannahAllison Powell, Savannah

J. Frank Reynolds, ColumbusJessica Rodery, Savannah

Kristina Sanford, ColumbusWendy Satterwhite, Graham, NC

Kyle Saunders, SavannahBeth Simpson, Savannah

Terica Simpson, SavannahSuzanna Singh, Concord, NC

Edie E. Smith, B.S., R.Ph., ReidsvillePamela Smith, SavannahTeresa Smith, Savannah

Christine Somers, SavannahBarbara Sona, SavannahCharity Speed, Savannah

Calandra Stafford, SavannahLuke Stamper, Atlanta

Laura Stanford, SavannahLauren Stansky, GainesvilleDeja Stephenson, SavannahKristin Talbott, Albany, KY

Benjamin Thomason, SavannahShelly Thompson, Pineview

Kristopher Tidwell, SavannahVictoria Tootle, Jacksonville, FL

Kimberly Tucker, SavannahJessica Vaughn, Savannah

Joni Vickers, SavannahNicole Wardenski, Iselin, NJ

Margarette Westwood, Pensacola, FLRichard Wilhoit, Savannah

Charity Wilkerson, Jacksonville Beach, FLDonell Williams, Savannah

Rebecca Wise, GuytonLindsay Wolfe, Savannah


G P h A M E M B E R S I N T H E N E W S

Ashley S. Hutchins, Pharm.D., andspouse, Adam Hutchins welcomed sonDavid Wilkin Hutchins on March 13,2008. Ashley is the daughter of the lateDavid J. Simpson, Jr., R.Ph.

Greg Hickman, R.Ph.’s pharmacyCarmichael Drugs has moved into a new17,000 sq.ft. pharmacy in Monroe, GAwith a Hallmark Gold Crown Store,Compounding Lab with viewing window.They are utilizing McKesson PARATAfor refills and Fast Movers Robot System,and Design Concepts designed the store’sfixtures.

Hugh Chancy, R.Ph., owner of Hahira’sChancy Drug has been named to theLeadership Georgia Class of 2009. This isan honor bestowed upon 100 Georgianleaders by the Georgia Chamber ofCommerce.

Azza El-Remessy, R.Ph., AssistantProfessor at the University of Georgia,was chosen as a national grant reviewerfor the American Heart Association, apost he will hold for the next three years.He has also published two papers, one inInvestigative Ophthalmology & VisualSciences and the other in Molecular Vision.

Brad Phillips, Pharm.D., Professor andHead, Clinical and AdministrativePharmacy at the University of Georgia,presented “Clinical Pearls, Don’t FallAsleep on Resistant Hypertension” at the43rd American Society of Health SystemPharmacists Midyear Clinical Meeting inOrlando.

Bill Trinh, South University’s Class of2009, was awarded the OutstandingPharmacy Intern/Extern Award at theGSHP Annual Meeting held in Helen,Georgia, on October 25.

Dr. Curtis E. Jones, II, R.Ph., waspromoted to associate professor andappointed Associate Dean for

Administration and Academic Affairs atSouth University’s College of Pharmacy.

Dr. Melissa C. Jones, R.Ph. waspromoted to full professor at SouthUniversity’s College of Pharmacy.

Andrea L. McKeever, Pharm. D.,Associate Professor of Pharmacy Practiceat South University’s College ofPharmacy was recently elected to(GSHP) as the new Southeast GeorgiaDistrict Director. She was also electedSecretary/Treasurer of the ACCP DrugInformation PRN.

Michael A. Crouch, Pharm.D.,Professor and Chair of the Department ofPharmacy Practice at South University’sCollege of Pharmacy, receivedrecertification as a Board CertifiedPharmacotherapy Specialist with AddedQualifications in Cardiology until 2014.He published 2 articles inPharmacotherapy 2008 and Formulary2008 among many otheraccomplishments.

Curtis L. Pickels, R.Ph., was recognizedby Mercer University’s College ofPharmacy and Health Sciences for hisdedication to the school and for thedistinction he brings to his alma materthrough his community service.

The following GPhA members have beennamed to the 2008-2009 Student Councilfor Mercer University’s College ofPharmacy and Health Sciences: HillaryVolsteadt, President of ASP; NeelamPatel, President of Kappa Epsilon;Melinda Rowland, President of GSHP;Brial Patel, President Pro-Tem of theclass of 2012; Johnathan Hamrick,President of NCPA; Aimee ReinhardPresident of the class of 2010; AndreaGauld, President of Phi Lambda Sigma;Janice Hatcher, President of ASCP; KateGillette, President of Phi Delta Chi;Chloe Ledford, President of CPFI;

Tanea Chane, President of the class of2009; and Neha Nageshrao President ofthe class of 2011.

Laura “Gena” Tyson, Pharm.D. hasopened Dogwood Pharmacy in Nashville,Georgia.

Herbert W. Hatton, R.Ph., has beennamed President of the Mercer UniversityCollege of Pharmacy and Health SciencesAlumni Association.

Bill Hankla R.Ph., and GeraldineHankla, R.Ph., won the “Best in Show”trophy at the Antique and Special InterestCar Show at the Mercer UniversityCollege of Pharmacy and Health Scienceswith their 1951 Studebaker ChampionCoupe.

In MemoriamWe are sad to announce the passing ofMalcom Forte, Jr., R.Ph.

If you have an item that you would likeincluded in the GPhA Members in theNews section of The Georgia PharmacyJournal please email the item to KellyMcLendon at [email protected] orfax it to her attention at 404.237.8435.


P h a r m a c y N e w s

Get “Fresh” for Your Valentine10 Ways to Keep Your Breath Fresh

Call it by its fancy name, “halitosis,” and it won’t smellany sweeter. Bad breath is frequently a sign thatyou’re not keeping up with your oral health. The

source of this unpleasant odor is, in most cases, bacterialiving on your teeth, gums or tongue. Follow these ten tipsfor a breath of fresh air:

1. Brush your choppers twice each day. Better yet, brushafter every meal. If you eat lunch at work or school, keep anextra toothbrush there. Also, be sure to replace yourtoothbrush regularly. Every few months, swap your brush fora fresh one.

2. Reach between your teeth. Flossing daily helps youremove food particles from between your teeth, where yourtoothbrush just can’t reach. Flossing also helps keep yourgums healthy, preventing periodontal disease, which can alsolead to bad breath and the pratice is related to lowering therisk of heart disease. If using regular floss is difficult for you,try one of the many inter-dental cleaners available atpharmacies.

3. Pick up a water pick. Along with floss, a water pickreaches spots your toothbrush can’t, like under your tongueand into the back of your mouth.

4. Treat your tongue right. Bacteria can gather on thesurface of your tongue, so use a soft-bristled toothbrush or atongue scraper to clean it every time you brush.

5. Tap your inner teenager and chew gum. The act ofchewing (sugarless) gum stimulates the production of saliva,which naturally washes away bacteria and food particles. Ifyou suffer from a lack of saliva due to “dry mouth,” acondition sometimes caused by medication, let your dentistknow; he or she can help address the problem.

6. Don’t fall for the myth of mouthwash. Most mouthwashesmerely mask the smell of bad breath and don’t do anythingto solve the underlying problem.

7. Hydrate, hydrate, hydrate. Drink water regularly to keepyour mouth moist, and go easy on alcohol and caffeine, bothof which are dehydrating.

8. Turn off the tobacco. Smoking and chewing tobacco leadto bad breath. They also increase your risk of a host ofserious health problems, from periodontal disease to cancer.

9. Take note of what you take in. Certain diets, foods andmedications can affect your breath. If your problem doesn’tappear to be oral, make a list of the foods you eat andmedications you take. Review it with your dentist,pharmacist or your family doctor to assess the source of theproblem.

10. Call in the experts. It’s important to have your teethprofessionally checked and cleaned twice a year. Your dentistcan give your teeth a thorough cleaning that isn’t possible athome, as well as check for and treat early signs of problemssuch as cavities or periodontal disease.

In rare cases, persistent bad breath can be a sign of a largerhealth problem. The American Dental Association listspossible medical sources of bad breath, including respiratoryinfection, chronic sinusitis, postnasal drip, chronicbronchitis, diabetes, gastrointestinal disturbance, and liver orkidney ailments. If your dentist suspects that your breathproblem stems from a medical issue, he or she willrecommend speaking with your family doctor immediately.

Source - The America Dental Association 2008

by Trevor Miller, Director of Insurance Services - [email protected]


Call for awards nominations...The GPhA Awards Committee is seeking nominations for the following awards which will be presented at theGPhA 134th Annual Convention in 2009. A brief description and criteria of each award is included. Please selectthe award for which you would like to nominate someone and indicate their name on the form below. Deadline forsubmitting the completed nomination form is March 9, 2009. Nominations will be received by the AwardsCommittee and an individual will be selected for presentation of the Award at GPhA’s 134th Annual Convention atthe Marriott Sawgrass in Ponte Vedra Beach, FL.

Bowl of Hygeia Award (sponsored by Wyeth-Ayerst)Recognized as the most prestigious award in pharmacy, the Bowl of Hygeia is presented annually by GPhA and all statepharmacy associations. Selection Criteria: 1) The nominee must be a licensed Georgia pharmacist; 2) The Award is not madeposthumously; 3) The nominee is not a previous recipient of the Award; 4) The nominee is notcurrently serving nor has served within the immediate past two years as an officer of GPhAother than ex-officio capacity or its awards committee; 5) The nominee has an outstandingrecord of service to the community which reflects will on the profession.

Distinguished Young Pharmacist Award

(sponsored by Pharmacist Mutual)Created in 1987 to recognize the achievements of young pharmacists in the profession, theAward has quickly become one of GPhA’s most prestigious awards. The purpose of the Award istwo-fold: 1) The encourage new pharmacists to participate in association and communityactivities, and 2) To annually recognize an individual in each state for involvement in anddedication to the pharmacy profession. Selection Criteria: 1) The nominee must have receivedentry degree in pharmacy less than ten years ago; 2) Nominee must be a licensed Georgiapharmacist; 3) Nominee must be a GPhA member in the year of selection; 4) Nominee must beactively engaged in pharmacy practice; 5) Nominee must have participated in pharmacyassociation programs or activities and community service projects.

Innovative Pharmacy Practice Award (sponsored by NASPA/GPhA)This Award is presented annually to a practicing pharmacist who has demonstrated innovativepharmacy practice which has resulted in improved patient care. Selection Criteria: 1) Thenominee must have demonstrated innovative pharmacy practice which has resulted inimproved patient care; 2) Nominee must be a licensed Georgia pharmacist; 3) Nominee must bea member of the GPhA in the year of selection.

2009 Awards2009 Bowl of Hygeia Distinguished Young Pharmacist Innovative Pharmacy Practice Award

Nominee’s Full Name _______________________________________________ Nickname ___________________

Home Address _________________________________________ City _______________ State _____ Zip ______

Practice Site __________________________________________________________________________________

Work Address __________________________________________ City _______________ State _____ Zip ______

College/School of Pharmacy _____________________________________________________________________

List of professional activities, state/national pharmacy organization affiliations, and/or local civic church activities:

____________________________________________________________________________________________

____________________________________________________________________________________________

Supporting information: _________________________________________________________________________

____________________________________________________________________________________________

Submitted by (optional): _________________________________________________________________________

Submit this form completed by March 9, 2009 to:

GPhA Awards Committee, 50 Lenox Pointe, Atlanta, GA 30324. Complete this form online at www.gpha.org.

Call fornominationsGPhA 134th

AnnualConvention

2009


GPhA Convention June 20-24, 2009Sawgrass Golf Resort and Spa, Ponte Vedra Beach, Florida

Register Online Today for...

Preserving the Triad

GPhA Registration Type Early Bird 5/1-6/1 After 6/1GPhA Member $295 $320 $345GPhA Member with Spouse or Guest and Student Sponsorship $660 $710 $735GPhA Member with Spouse or Guest $535 $585 $610GPhA Member with Student Sponsorship $420 $445 $470Spouse or Guest Only Registration (Does Not Include CE) $240 $265 $265GPhA Non-Member $470 $495 $520GPhA Non-Member with Spouse or Guest and Student Sponsorship $835 $885 $910GPhA Non-Member with Spouse or Guest $710 $760 $645GPhA Non-Member with Student Sponsorship $595 $620 $645

Convention Registration Fee: includes admittance to CE Sessions, Sunday Opening Dinner, All Refreshments, Exhibits and Entertainment, President’sReception, Awards Banquet,Coffee/Dessert Reception.

GPhA’s 2009 Convention will be held at the Sawgrass Golf Resort and Spa in June. Thisis a favorite venue of GPhA members. With quick access to the gorgeous beach, a spacious and luxurious hotel and spa, and delicious food, we are assured a relaxing and educational convention.

GPhA offers an “early bird” convention rate through the end of April. Hotel rooms fillquickly so make your reservations now and plan to attend the 2009 Convention. Register online at www.gpha.org.

Sawgrass Golf Resort and Spa, A Marriott Resortwww.sawgrassmarriott.comFor Resort Reservations call: 1.800.457.4653Room Block Expires 5/15/2009 so make your reservations today!Single or Double Room $179Island Green Villa Suite (1 Bedroom and Full Kitchen) $254

Substitution Bill(s)

Many of you remember these bills from lastyear – epilepsy, immunosuppressant, anti-psychotics, etc. These bills would requirethe patient to only receive name-brandmedication that falls into specific diseasecategories.

These bills will be introduced again.Sources say the Alzheimer’s Associationwill be introducing a similar bill.

We have opposed these bills on the groundsthat pharmacists would not be reimbursedfor the drugs. We are working to find a bill

that would take care of the issue at hand without the need fornumerous pieces of legislation.

Drug Monitoring

This piece of legislation sets up a centralautomated database of all dangerous drugsdispensed in Georgia. This information ispresently collected by pharmacists andlegally available to Georgia Drugs andNarcotics agents. The purpose of this bill isto curtail the diversion of controlledsubstances. No cost to the pharmacist isassociated with this program and thedatabase will be accessible to pharmacistsand physicians in Georgia.

State Representative Ron Stephens,R.Ph., will be the primary sponsor of theDrug Monitoring bill.


Pharmacy Benefits Manager Licensure Bill

As of December 19, the PBM legislation that we will beintroducing in the Senate has been drafted. Senator LeeHawkins from Gainesville will be the primary sponsor. Thebill will do the following:

• License all Pharmacy Benefit Managers in the State ofGeorgia under the Department of Insurance• Requires a PBM to provide for a surety bond• Creates enforcement of the existing ‘Audit Bill of Rights’• Provides that a PBM owes a fiduciary duty to the coveredindividual

Georgia pharmacists have done an amazingjob contacting their legislators andeducating them on the importance of PBMlegislation. Please take the time today tocall their capitol office in Atlanta toreinforce this same point.

Immunization

GPhA and the Medical Association of Georgia have workeddiligently to forge a relationship between our organizations.That relationship has created an avenue to respectfullynegotiate terms related to legislation regarding immunization.

We have been working with the Governor’s office to have thisbill become a part of the Governor’s legislative agenda. Wereceived a call on January 6 from the Governor’s office statingwe were successful in doing this. The Governor’s office will becarrying immunization as a part of his 2009 legislative agenda.Thankfully, this bill will now be thought of as a public healthissue (which it is) and not a pharmacist issue.

Our goal is to pass this bill in the first weeksof the session so our pharmacists canattempt to salvage a portion of the fluseason.

Thank You to GoodSense

In December, GoodSense gave the Association, free of charge, 350 bottles of 200mg tablets of ibuprofen. Our government affairsdepartment placed a sticker on these bottles that read, “For all of your Legislative Session headaches” and distributed them to all ofthe Georgia state legislators and their assistants. Compliments have been pouring in from these actions and it looks like we havestarted a good thing.

It is important for the association to continue these types of activities so legislators can be aware of our presence at the capitol.Please patronize GoodSense for their help in these matters and thank them when you have the opportunity.

GPhA’s February Legislative Updateby Stuart Griffin, Director of Governmental Affairs - [email protected]

G P h A U P D A T ES A V E T H E D A T E

Become a part of GPhA’s grassroots team and support your profession!

February 18, 2009Very Involved Pharmacist Day

Georgia State Capital

– –May 12, 2009

Eggs and Issues BreakfastWashington, D.C.

Check www.gpha.org and future issues of the Georgia Pharmacy Journal formore information about these and other important upcoming events.



Help Make GPhA the Most Powerful Grassroots Force in Georgia

2008 2009 GrassrootsSignUp Form

Please complete and return via fax to GPhA at 404.237.8435

Your Name: __________________________________________________________________

Preferred Address: _____________________________________________________________

City, State Zip Code: ___________________________________________________________

Preferred Phone(s):_____________________________________________________________

Email Address: ____________________________________ Fax: ________________________

How do you prefer to receive legislative information? (Select One)Email Fax

Which of the following activities are you willing to perform to assist GPhA’s legislative efforts?Write A Letter Phone Call Personal Visit Testify On A Bill

Have you made a financial contribution to the campaign of any legislator in the past 4 years? If yes, pleasecomplete the form below. For nature of relationship, indicate how you know the legislator (business, childhoodfriend, college, church, civic, family, campaign volunteer, etc.).

Yes No

*** Confidential - For GPhA File Only ***Your Legislators Legislator’s Name Amount Nature of Relationship

State Representative: ___________________________________________________________________

State Senator: ________________________________________________________________________

US Representative: _____________________________________________________________________

US Senator: _________________________________________________________________________

Another successful Southeastern PRN Conference hostedby the Georgia Pharmacy Foundation and GeorgiaPharmAssist Committee for the 13th year was held at

beautiful Simpsonwood Conference Center in Norcross,Georgia located just north of Atlanta. This conference is a hugesuccess due to the commitment and dedication of two of ourmembers, Jim Bartling, Pharm.D., CAC II, InterventionCoordinator, Georgia PharmAssist Program, and Richard B.Smith, R.Ph., Chairman of the Georgia PharmAssist Program.They have spearheaded this conference from the beginning andare the backbone to its continued success. They are trueadvocates for those with special needs.

GPhA Chairman, Sharon M. Sherrer, Pharm.D., CDM, theFoundation’s Chairman, John T. Sherrer, R.Ph., and theGPhA’s Executive Vice President/CEO, Jim Bracewell, were inattendance to welcome all the participants, and to thank theexhibitors for their support.

Due to the success of this conference covering 13 years, it isrecognized across the country and has attendees coming fromacross the nation, not just the southeast. One of the mostwidely known websites with PRN information,www.usaprn.org, promotes this conference and has photosfrom some of the meetings.

Samford University’sMcWhorter School ofPharmacy continues toinclude this Conference aspart of their curriculum. Dr.Valerie Prince promotesthis program and is a bigadvocate of her studentsparticipating. Jim Bartling,Pharm.D., Associate Deanfor Student Affairs andAdmissions at MercerUniversity College ofPharmacy & HealthSciences, encourages hisstudents to attend and hada large contingent this year.We are hopeful UGA andSouth will promote future

conferences to their students. Each student receives a certificateacknowledging their participation in this Conference.

Pharmacy Technicians are encouraged to attend. They alsoreceive CE credits for their participation. This conference isopen for anyone who wants to learn more about the disease ofaddiction. There are a number of attendees who come everyyear or almost. Many treat the conference as a reunion time, buteach year they are amazed at what new information they learnand can’t wait to attend the following year. First-timeparticipants are usually “blown away” by what they learn, andthat applies especially to the students.

This year’s program included the opening presentation onSaturday by Dr. James D. Vargo, the Medical Director atRidgeview Institute, discussing “Alcohol Dependence,Diagnosis, Neurobiology and the Clinical Course.” MichaelQuigley, R.Ph., Executive Director for the PharmacistsRehabilitation Organization for Ohio, covered “RelapsePrevention & Professional Monitoring.” Kevin Rich, D.Ph.,President of Oklahoma Pharmacists Helping Pharmacists, gavea personal story titled “The Oklahoma Pharmacy RecoveryProgram & Me – A Personal Journey” that captured everyone’sattention. One of the Pharmacy Recovery Network’s favorite

speakers, Merrill Norton,Pharm.D., D.Ph., NCAC II,CCS, Clinical AssistantProfessor at UGA, made apresentation on “TheAddiction PharmacySeries: Pain & the AddictedPatient” that was veryinformative. The Saturdayafternoon finalpresentation was made byTom House who is aNational ComplianceConsultant from Louisville,KY. His program was titled“Value of Urine Analysis asan Assessment ofMonitoring Tool forMedical Professionals.”


U P C O M I N G E V E N T S

The 13th Annual Southeastern PRN ConferenceHeld November 14-16, 2008

Attendees with Exhibitor signs behind them.


On Sunday another favorite speaker, Brian Fingerson, R.Ph.,President of Brian Fingerson, Inc., dba KY ProfessionalsRecovery Network, spoke on “AA = A Religion, A Cult or…ASimple Spiritual Program of Recovery.” Chip Abernathy, LPC,CAC, Program Coordinator of Recovering ProfessionalsServices at Ridgeview Institute, presented “Stages of Recovery:Gorski’s Developmental Model of Recovery.”

The Georgia Pharmacy Foundation and Georgia PharmAssistCommittee want to thank the following Exhibitors andSponsors for their support of this Conference:

GPhA’s Academy of Independent Pharmacy (AIP)Center for Professional Excellence (CPE)

Palmetto Addiction Recovery CenterQuestHouse, Inc.

Ridgeview InstituteTalbott Recovery Campus

Their assistance helped make this Conference possible and isvery much appreciated. We also thank each representative whoattended the Conference for their contributions to its success!We look forward to seeing you at next year’s Conference.

Mark Your 2009 Calendar!Next year’s SE PRN Conference will be held at

Simpsonwood on November 13-15, 2009

Should you or someone you know need assistance with anaddiction issue, please do not hesitate to call the:

PharmAssist Hotline Number (24 hours/7 days a week)404-362-8185

Your call will be returned as quickly as possible.

Southeastern PRN Students

Standing from left to right: Jim Bartling, Pharm.D.;Richard Smith, R. Ph.; Brian Fingerson, R.Ph.; andKevin Rich, D.Ph. with Southeastern PRN student.

Financial Planningfor Georgia’s Pharmacists

Michael T. Tarrant

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Building Wealth & Security

Financial Network Associates

1117 Perimeter Center West, Suite N-307

Atlanta, GA 30338 • 770.350.2455

[email protected] www.fnaplanners.com

Securities, certain advisory services and insurance products are

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advisory services may be offered through Financial Network

Associates, Inc., a registered investment adviser.


G E O R G I A P H A R M A C Y S C H O O L S ’ N E W S

Mercer University College of Pharmacy and Health Sciences News

In January, students of Mercer University's College ofPharmacy and Health Sciences and Georgia BaptistCollege of Nursing participated in the Health and WellnessForum hosted by Aetna and the King Center of Atlanta.The King Holiday Theme this year was “Remember!Celebrate! Act! A Day On, Not a Day Off.” The themereminds us of the importance of Dr. Martin Luther KingJr.'s work, legacy, and his teachings of nonviolence andhuman rights. It also serves as a reminder that “the holidayis a day on for community service initiatives and programspromoting interracial cooperation, not just a day off fromwork or school.” The Health and Wellness Forum provided

information, education and services to empower people inthe areas of health, wellness and nutrition to address thedisparities in our communities. The Forum specificallyaddressed childhood obesity, diabetes, HIV/AIDS, andasthma. In the Health and Wellness Fair, Mercer Universitystudents provided blood pressure, blood glucose,heartburn and body mass index screenings. Otherorganizations performed screenings and tests forcholesterol, osteoporosis, skin cancer, vision, hearing,asthma, dental, breast cancer, HIV/AIDS, and lungcapacity. These organizations include CDC, Merk & Co.,Sickle Cell Foundation, West End Medical Center,Northside Hospital, Morehouse School of Medicine,

Grady Health Systems, Diabetes Association of Atlanta,and the Fulton County Department of Health andWellness. The students also provided information andanswered questions regarding immunizations, diabetes,deep vein thrombosis, cholesterol and obesity. MercerUniversity screened over one hundred patients, while theentire event reached over one thousand people of thecommunity. Providing these services was extremelyrewarding to all of the students. The health fair ended withthe highlight of meeting and screening Dexter Scott King,Dr. King’s nephew and the Chairman, President and CEOof the King Center.


University of Georgia College of Pharmacy News2009 Mental Health SymposiumOn February 4-5 the University of Georgia is holding the2009 Mental Health Symposium at the Tate StudentCenter Reception Hall. The first day is apsychopharmacology update and the second day will focuson pharmacogenomics.

James Bruckner, UGA Professor Named asPeer ReviewerDr. James Bruckner has been named to serve as a peerreviewer for “Toxicology of N-Nonane in Jet Fuels” for theSuperfund Health Risk Assessment Center of the U.S. EPA.

He also served as one of five national experts to review“Interim Safety and Risk Assessment of Melamine and itsAnalogues in Food for Humans” for the Center for FoodSafety, U.S. FDA. Melamine is a chemical contaminant

responsible for kidney failure of cats and dogs in the U.S.and more recently for kidney disease in more than 100,000children in China.

Michael Neville, UGA Clinical AssociateProfessor achieves certif icationDr. Michael Neville passed the Board of PharmaceuticalSpecialties National Certification Exam inPharmacotherapy in October.

Timothy Long, UGA Assistant ProfessorReceives GrantDr. Timothy Long received a $10,000 AmericanAssociation of Colleges of Pharmacy New InvestigatorsGrant Program award for the proposal “Novel beta-LactamAntibiotics for Resistant Bacteria.”

G E O R G I A P H A R M A C Y S C H O O L S ’ N E W S

South University School of Pharmacy NewsDoctor of Pharmacy Student Recognized asan Outstanding Intern The Outstanding Pharmacy Intern/Extern Award waspresented to South University student Bill Trinh, Doctorof Pharmacy Candidate Class of 2009, at the GSHP(Georgia Society of Health-System Pharmacists) AnnualMeeting held in Helen, Georgia, on October 25. The awardrecognizes excellence in future pharmacists. Nominationsare presented by preceptors, educators, or any other GSHPmember who has had direct contact with an intern orextern who has shown exemplary service in this role.

Bill Trinh has been a student chapter president of Societyof Health-System Pharmacists. During his time as

president, Bill has reorganized the chapter to formcommittees to assist with fundraising, both for the chapter and the overseas charities, web site development, andmembership recruitment leading to increased awarenessabout the chapter. In addition to his work with the studentsociety, he works as an intern with CVS and with theirsupport helped to organize a heartburn awarenesscampaign. Dr. Kimberly Tackett is the faculty advisor forthe student chapter.


w w w . g p h a . o r gV i s i t t h e G P h A C a r e e r C e n t e r

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1984—Twenty-five years ago:• Drug Price Competition and Patent Term Restoration

passed. The major provisions of the law: o expedited the availability of less costly generic

drugs by permitting FDA to approve applications to marketgeneric versions of brand-name drugs without repeating theresearch done to prove them safe and effective.

o provided brand-name companies up to fiveyears additional patent protection for new medicines to make upfor time in FDA's approval process.

• Schering Corporation budgeted $4 million for first “AskYour Pharmacist” campaign to encourage the public to ask theirpharmacists about their medicines

1959—Fifty years ago• American Hospital Formulary Service launched by

American Society of Hospital (now Health-Systems)Pharmacists

1934—Seventy-five year ago• The American Pharmaceutical (now Pharmacists)

Association headquarters building, the American Institute ofPharmacy, on the National Mall in Washington, DC wasdedicated

1909—One hundred years ago• Opium Exclusion Act of 1909 prohibited the

importation of opium to the United States.By: Dennis B. Worthen Lloyd Scholar, Lloyd Library and

Museum, Cincinnati, OH

One of a series contributed by the American Institute of the History ofPharmacy, a unique non-profit society dedicated to assuring that the contributionsof your profession endure as a part of America's history. Membership offers thesatisfaction of helping continue this work on behalf of pharmacy, and brings five ormore historical publications to your door each year. To learn more, check out:www.aihp.org

Pharmacy Time Capsules2009 (First Quarter)


Gossel Wuest

Thomas A. Gossel, R.Ph., Ph.D.Professor EmeritusOhio Northern UniversityAda, Ohio

J. Richard Wuest, R.Ph., PharmDProfessor Emeritus

University of CincinnatiCincinnati, Ohio

Natural Products:Goldenseal, Gotu Kola, Grapeseed Extract, Green Tea

Volume XXVI, No. 10

Goals. The goals of this lesson areto present information on the claims,mechanisms of action, typicaldosages used and other items ofinterest on natural products andnutraceuticals alphabetically fromgoldenseal to green tea, and toprovide background information forassisting others on their properselection and use.

Objectives. At the conclusion ofthis lesson, successful participantsshould be able to:

1. exhibit knowledge of theclaims, mechanisms of action andtypical dosages for natural productsand nutraceuticals presented;

2. select from a list, thesynonyms for these products; and

3. demonstrate anunderstanding of information thatcan be used when discussing theseproducts with consumers.

GOLDENSEALGoldenseal (Hydrastis canadensis),also known as eye balm, eye root,goldenroot, goldsiegel, groundraspberry, hydrastis, Indian dye,Indian plant, Indian tumeric,jaundice root, orange root, turmericroot, warnera, wild curcuma, yellowIndian paint, yellow paint, yellow

puccoon, and yellow root, is an herbfound in the midwestern areas of theUnited States along the Ohio rivervalley running up into thenortheastern parts of the country.While it is indigenous to the U.S., it isnow cultivated in many other areas ofthe world.

Goldenseal is a horizontalbright yellow plant with knotty andtwisted rhizomes (creepingunderground stems) out of whichroot fibers grow. These are themedicinal parts of the herb. They areharvested in the autumn, air driedand ground for use. The taste is verybitter and its odor is strong anddisagreeable. The plant received itsname from the goldenyellow scars onthe rhizomes. When they are broken,the scars resemble the gold wax letterseals used in Colonial days. Thecoloration comes from the largeamounts of the yellow alkaloidberberine, which is one of theconstituents of goldenseal. Otherbioactive components of goldensealinclude canadine, canadaline andhydrastine.

American Indians usedgoldenseal root as a diuretic, tonic,insect repellent, and for irritated andinflamed eyes. They also used it totreat arrow wounds and to make ayellow dye.

Today, goldenseal is used totreat the symptoms of the commoncold, flu, whooping cough and otherupper respiratory infections, chronicfatigue syndrome, colitis,constipation, diarrhea, dysmenorrheaand excessive menstrual flow,flatulence, gastritis, gonorrhea, hayfever, hemorrhoids, jaundice, liverdisease, loss of appetite, malaria,peptic ulcer disease, post-partumbleeding, urinary tract infections andvaginitis.

Topically, goldenseal is usedas a mouthwash for sore gums andirritation of mucosal tissue. It is usedon the skin for acne, eczema,infections, itching, rashes, seborrhea,ulcers and infections, includingringworm and herpes. In the eye, it isused for inflammation, conjunctivitisand redness. Goldenseal is used in theears for earache and tinnitus.

In homeopathic medicine,goldenseal is used for treatment ofbronchitis, digestive problems andirregular menstruation.

There is a traditional beliefthat goldenseal can be used to affectthe outcome of urinalysis for illicitdrugs by being ingested prior totesting or adding it to the urinesample after collection. It is reportedto be commonly detected in


urinalysis in drug screeningprograms. This concept dates back toa novel, Stringtown on the Pike,written in the mid 1800s in whichgoldenseal bitters are mistaken forstrychnine in a simple alkaloid test byan expert witness in a murder trial.

It is of some interest that thenovel was one of several authored bya prominent pharmacist of his day,John Uri Lloyd. He was also afounder of the Cincinnati College ofPharmacy, cofounder of theAmerican PharmaceuticalAssociation, the “Father of eclecticpharmacy” and developer of theextensive line of “Lloyd’s Specifics.”For historical perspective, eclecticpharmacy was the systematiccollection and testing of substances(mostly herbs and plants) ofpotential medicinal value andselecting the best and most desirablefor treating complaints and diseases.Eclectic pharmacy bridged the gapbetween leeches, strong laxatives andunproven remedies and today’sscientific- and chemical-basedtherapeutic practice.

Proponents of the use ofgoldenseal claim that its componentsinhibit the growth of severalmicroorganisms, includingChlamydia trachomatis, Shigelladysenteriae, Salmonella paratyphi,Klebsiella, Mycobacteriumtuberculosis and Helicobacter pylori.

Berberine is reported to havecholeretic (bile-stimulatory),hypotensive, antisecretory andsedative effects. Detractors of its usereport that the alkaloids of goldensealare poorly absorbed when givenorally and might not reach adequateconcentrations in the body toproduce significant pharmacologicactivity. Conversely, proponents ofthe use of goldenseal state that thefact they are detectable in urineattests to their absorption andsystemic activity.

When taken orally inappropriate doses for short-term usein adults, goldenseal appears to besafe. However, very high doses mayrarely cause nausea, anxiety,depression, seizures and paralysis.Goldenseal is contraindicated for use

during pregnancy and lactation.Berberine reportedly crosses theplacenta and may harm the fetus.Kernicterus has developed innewborn infants exposed togoldenseal. It also can be excreted inbreast milk.

The traditional dose ofgoldenseal is 250 to 500 mg of extract(standardized to 5 percent hydrastinethree times a day. Also, 500 mg to 1gram of dried rhizome three times aday has been used.

GOTU KOLAGotu kola (Centella asiatica, C.coriacea), also known as brahmabuti,brahma-manduki, centella, centellase,divya, hydrocotyle, idrocotyle, IndianPennywort, Indian water navelwort,khulakhudi, madecassol,mandukaparni, manduk parani,mandukig, marsh penny, talepetrako,thick-leaved pennywort, tsubo-kusa,tungchian and white rot, is a slendercreeping plant that grows in swampyareas of India and Sri Lanka, southernChina, Madagascar, South Africa, thesouthern U.S., Mexico, Columbia,Venezuela, eastern South Americaand the South Sea Islands.

The medicinal portions ofgotu kola are the dried above groundparts, the fresh and dried leaves, andits stem. Highly used in Indian andChinese medicine, the plant isharvested throughout the year anddried in the sun.

People take gotu kola toreduce anxiety, depression andfatigue; to improve intelligence andmemory; to enhance circulation,decrease edema and treat varicoseveins; as an aphrodisiac as well as acontraceptive; and to increaselongevity. It has been used to treatsymptoms of the common cold andthe flu, abdominal pain, anemia,asthma, cholera, diabetes, dysentery,diarrhea, epilepsy, gastric and pepticulcers, gastritis, hepatitis, indigestion,jaundice, leprosy, pleurisy, peripheralartery disease, sunstroke, tonsillitis,shingles and urinary tract infections.Topically, gotu kola is used forwound healing and to reducescarring.

In homeopathic medicine,

gotu kola is used for skin diseasesassociated with itching and swelling,and to reduce inflammation of theuterus.

Gotu kola has severalconstituents that are thought to havepharmacologic activity. Theseinclude asiatic acid, madecassic acid,asiaticosides A and B, variousessential oils, flavonoids and flavonederivatives. There is evidence, but notconclusive proof, that gotu kolamight bind with cholecystokinin inthe intestine and GABA receptors inthe central nervous system.Cholecystokinin is a hormoneliberated by the intestinal mucosa oncontact with entering gastriccontents. It stimulates the gallbladderand the secretion of pancreatic juices.This would provide gastrointestinaland digestive effects.

GABA (gammaaminobutyric acid) is the principleinhibitory neurotransmitter in thecentral nervous system. If gotu koladoes significantly bind with GABAreceptors, this could provideantianxiety, sedative, analgesic andanticonvulsant activity. There areproponents of its use who believe thatgotu kola might protect neurons inthe brain from beta-amyloid (thesubstance thought to destroy neuronsin the hippocampus, which leads tomemory loss) toxicity and thus have arole in treating patients withAlzheimer’s dementia.

There are reports suggestingthat constituents of gotu kola seem tospeed up wound healing, have anti-inflammatory effect, improveconnective tissue remodeling byincreasing fibroblast (cells inconnective tissue that form collagen)activity, increasing epithelial cellturnover and decreasing capillarypermeability.

It has been proposed thatgotu kola might increase the collagencontent within arterial plaque. Sinceplaque with low collagen content arestructurally weak and linked to anincreased risk of rupture andembolism, gotu kola might helpstabilize arterial plaque. Proponentsfurther state that there is preliminaryevidence that it may have a

Volume XXVI, No. 10


strengthening effect on the gastricmucosal lining and suppress freeradical damage, thus providing usefulpreventative and therapeutic effectson gastrointestinal ulcers.

Taken in recommendeddoses, gotu kola is usually well-tolerated. However, there are reportsof gastrointestinal upset and nausea.Rarely, hepatotoxicity has beenassociated with its use. When usedtopically, gotu kola can rarely causeallergic contact dermatitis.

The typical oral dose of gotukola is 60 mg of its extract two tothree times a day. One percentcreams have been used topically forwound healing.

GRAPESEED EXTRACTGrapeseed (Vitis vinifera), alsoknown as activin, calzin, enocianina,European wine grape, flame grape,leucoanthocyanin, muskat,oligomeric proanthocyanidins,oligomeric procyanidins, OPC,PCOs, petite sirah, proanthodyn,procyanidolic oligomers and sultanas,is indigenous to southern Europe andwestern Asia. However, it iscultivated in most temperate regionsof the world.

The medicinal portions ofgrape plants are considered to be theleaves, fruit and flowers. Grapeseedextract, the most used and studiedportion, is generally obtained as a by-product of wine production.

Although wine has been abeverage ingested by humans formillennia, the use of grapeseedextract for medicinal purposes is arelatively recent event. Its popularityincreased in the Western World withthe French using it to treat venousand capillary disorders such asretinopathies, venous insufficiencyand vascular fragility. This has beenreported to be the result of what hasbeen called the French Paradox. Theobservation has been made that eventhough the French have a high dietaryintake of fatty foods, this is notassociated with a higher occurrenceof atherosclerosis and othercardiovascular diseases seenelsewhere in Europe and NorthAmerica. Allegedly, this is due to their

high intake of wine and wine by-products.

Grapeseed extract is used infolk medicine for preventingcardiovascular diseases,atherosclerosis, cerebral andmyocardial infarction, hemorrhoids,hypertension, peripheral vasculardisease and varicose veins. It is alsoused for the complications ofdiabetes, such as neuropathy; allergicrhinitis; age-related maculardegeneration, poor night vision; toimprove wound healing; and toprevent dental cavities, cirrhosis ofthe liver, cancer and the breakdownof collagen.

The therapeutic activity ofgrapeseed extract is attributed to itscomponent proanthocyanidins,which are members of a group ofcompounds called flavonoids. Thesesubstances are claimed to have a widevariety of effects, includingantioxidant, vasodilatory,antilipoperoxidant activity andantiplatelet aggregation properties,all of which would be helpful intreating heart disease.

Proanthocyanidins areresponsible for producing the redcolor of grapes. The red varieties ofgrapes reportedly provide greaterantioxidant activity than the white orblush categories, with red winescontaining approximately 10 timesmore proanthocyanidins than whitewines.

Other flavonoid constituentsof grapeseed extract include catechin,kaemferol (aka kaempferol),myricetin and quercetin. Catechinreportedly can inhibit low-densitylipoprotein oxidation, and the othershave antioxidant activity as well.Catechins might inhibit allergen-induced histamine release from mastcells.

Flavonoids also appear todecrease superoxide production,increase nitric acid release fromplatelets and increase the levels ofantioxidants, such as alphatocopherol(vitamin E) from storage in the body.Claims are made that grapeseedproanthocyanidins may producegreater protection against reactiveoxygen species, free-radical induced

lipid peroxidation and DNA damagethan combinations of vitamin C andvitamin E, with or without beta-carotene (vitamin A).

Grapeseed extract is welltolerated, with no adverse eventsreported at a higher level ofoccurrence than those seen withplacebo.

The typical dose of grapeseedextract for treating chronic venousinsufficiency using commerciallyavailable products is 75 to 300 mgdaily for three weeks followed bymaintenance doses of 40 to 80 mgdaily. For cardiovascular protectiveeffects, 150 to 300 mg ofproanthocyanidins from grapeseedextract is suggested.

GREEN TEAGreen tea (Camellia sinensis, C. thea,C. theifera, Thea bohea, T. sinensis,T. viridis), also known as Chinese tea,epigallo catechin gallate, andJapanese tea, is a large evergreenshrub native to eastern Asia.Although originally cultivated inChina, the tea plant is now grown inextensive amounts for commercialpurposes in Argentina, India,Indonesia, Japan, Kenya, Malawi,Pakistan, Sri Lanka and Turkey.

The tea plant has leathery,dark green leaves and fragrant, whiteflowers. The dried, cured leaves ofgreen tea have reportedly been usedmedicinally for more than 5,000 yearsto promote digestion, improvemental faculties, decrease flatulenceand regulate body temperature.

It is no news bulletin to statethat other than water, tea is the mostwidely ingested beverage around theworld, with the exception of theUnited States, where coffee hasbecome the most popular beverage.Elsewhere, tea is used at meals,ceremonies, celebrations andrelaxation time. What is not generallyknown is that the three major types oftea, black, green and oolong, do notdiffer in the species of plant on whichthe leaves grow. Rather, thedifference is in the way the leaves areprocessed after they are harvested.

Black and oolong tea areproduced by fermenting and

Volume XXVI, No. 10


oxidizing the young tea leaves. Blacktea is fully fermented and oolong teais partially fermented. Green tea isproduced by steaming fresh leaves athigh temperatures. This inactivatesthe oxidizing enzyme components,leaving the polyphenol flavonoidcontent intact (i.e., catechin,epicatechin, epigallocatechin, andgallocatechin). Green tea hasapproximately six times heantioxidant activity as the other twotypes. All three types of tea containsimilar amounts of caffeine,theobromine, theophylline andtannins until they are commerciallyprocessed.

Green tea is taken toimprovemental alertness andcognitive performance. The CNSstimulant effect of green tea is due toits caffeine content, which averages 2to 4 percent, or 10 to 80 mg per cup,depending on how much tea is usedand how long it is brewed.

It is also used as a diuretic; incombination with other herbs forappetite suppression; and to treatdiarrhea, stomach disorders,vomiting and headache. It has alsobeen used to reduce the risk of breast,colon, gastric, lung, prostate and skincancer, and to treat solid tumorcancers. Other uses include treatingcardiovascular disease, chronicfatigue syndrome and Crohn’sdisease, diabetes, hypertension,kidney stones, migraine, andParkinson’s disease.

Topically, green tea has beenused as a wash to soothe sunburn, as apoultice for “bags” under the eyes, asa compress for tired eyes andheadaches, and to stop bleeding fromthe socket after tooth extraction.

In homeopathic medicine,green tea is used to treat agitation,cardiac and circulatory conditions,depression, headache and stomachcomplaints. In Indian medicine,green ea preparations are used forcardiac pain, diarrhea, loss of appetiteand migraine. In Chinese medicine,green tea is used to treat diarrhearesulting from digestive problems,malaria, migraine and nausea. It hasalso been used in China as a cancerpreventative.

There is little doubt that inmost people, consumption of greentea (and any other caffeinatedbeverage) will increase mentalalertness and improve cognitiveperformance. There is evidence thatcombining caffeine-containingbeverages with glucose as “energy”drinks may improve mentalperformance better than placebo oreither caffeine or glucose alone.

There is some, butinconclusive, evidence that drinkinggreen tea may reduce the risk ofbladder, esophageal, gastric andpancreatic cancer, as well as breastand ovarian cancer recurrence.Drinking green tea on a daily basisseems to lower cholesterol andtriglyceride levels, as well as the riskof hypertension, and to help preventor delay the onset of Parkinson’sdisease. But, none of the studiesreporting these effects meet therigorous standards needed for FDAapproval of such claims.

There is insufficient reliableevidence that consuming green tealowers the risk of developingdiabetes, lung cancer, ischemic heartdisease and death after myocardialinfarction, or that it is useful forweight reduction in obeseindividuals.

Other pharmacologicactivities attributed to caffeineinclude increased release ofdopamine; decreased airwayresistance along with stimulation ofrespiration; decreased gammaaminobutyric acid (GABA) andserotonin signaling; positiveinotropic and chronotropic effects onthe heart; elevation of both diastolicand systolic blood pressure (but notin chronic users); and a diureticeffect.

The proposed mechanism ofaction of the polyphenol flavonoidscontained in green tea include anantimutagenic effect that may protectDNA, inhibit tumor cell proliferation,cause cell cycle arrest and cancer celldeath. Animal research suggests thesecomponents may do this via reactiveoxygen species formation andmitochondrial depolarization.

Polyphenol flavonoids are

claimed to reduce cellularadhesiveness of bacteria associatedwith dental disease. Further claimsare made that they prevent skindamage and cancer caused byultraviolet radiation by means of theirantioxidant effect.

Although some individualscannot tolerate green tea and thosewith conditions adversely affected bycaffeine should avoid it, there is a lackof reports of clinical toxicity fromdaily consumption of moderateamounts of green tea. However, thereare reports of excessive CNSstimulation (such as dizziness,insomnia, agitation, restlessness,tremors, fatigue, confusion), nausea,vomiting, abdominal bloating andpain, upset stomach, flatulence anddiarrhea resulting from ingestion oflarge amounts of green tea or highdoses of green tea extract, equivalentto five or more liters of tea per day.

Large doses of caffeine canalso cause massive catecholaminerelease leading to irregular heartbeat,metabolic acidosis, hyperglycemiaand ketosis, headache, anxiety,ringing in the ears, hypokalemia,respiratory distress and chest pain.Having reported all this, it should bepointed out that the dailyconsumption of moderate amountsof green tea seems to cause no healthproblems.

The typical doses of green teavary significantly, ranging up to 10cups per day. The commonly useddose consumed for medicinalpurposes in tea-drinking nations isaround three cups per day using oneteaspoonful of powdered tea in eightounces of boiling water. This wouldprovide 240 to 320 mg of polyphenolflavonoids.

The content of this lesson wasdeveloped by the Ohio PharmacistsFoundation, UPN: 129-999-09-002-H01-P. Participants should not seekcredit for duplicate content.

Volume XXVI, No. 10


1. All of the following are synonyms for goldenseal EXCEPT:a. centella. c. hydrastis.b. ground raspberry. d. Indian tumeric.

2. The coloration of goldenseal comes from its large content ofthe alkaloid:a. atropine. c. hydrastis.b. berberine. d. Indian tumeric.

3. The systematic collection and testing of plants of potentialmedicinal value and selecting the best for treating complaintsis called:a. organic pharmacy. c. homeopathic pharmacy.b. naturopathic pharmacy. d. eclectic pharmacy.

4. The medicinal portions of gotu kola include all of thefollowing EXCEPT the:a. fresh leaves. c. roots.b. stems. d. dried leaves.

5. There is evidence, but not conclusive proof, that gotu kolamight bind with which of the following substances in the body?a. Pepsinogen c. Hydrochloric acidb. Intrinsic factor d. Cholecystokinin

dâ|éNatural Products: Goldenseal, Gotu Kola,Grapeseed Extract, Green Tea

The Georgia PharmacyAssociation is accredited by theAccreditation Council for

Pharmacy Education as a provider ofcontinuing pharmacy education.Natural Products: Goldenseal, Gotu

Kola, Grapeseed Extract, Green TeaVolume XXVI, No. 10GPhA Code J09-02Program Number: 142-999-09-002-H01-PCE Hours: 1.5 (0.15 CEUs)Release Date: 2/5/2009Expiration: 10/15/2011

1. Select one correct answer per question and circle theappropriate letter below using blue or black ink (no red inkor pencil).

2. Members submit $4, Non-members must include $10 tocover the cost of grading and issuing statements of credit.Please send check or money order only. Note: GPhAMembers will receive priority in processing CE.Statements of credit for GPhA members will be mailed

within four weeks of receipt of the course quiz.

1. A B C D 6. A B C D2. A B C D 7. A B C D3. A B C D 8 A B C D4. A B C D 9. A B C 5. A B C D 10. A B C D

Mail completed quiz to: GPhA, 50 Lenox Pointe NE, Atlanta, GA 30324

A passing grade of 70% is required for each examination. A person who fails the exam may resubmit the quiz only once at noadditional charge.

Please check here if you are indicating a change of address ______ Phone # __________________

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6. The popularity of using grapeseed extract increased in theWestern World with the French using it to treat all of the followingailments EXCEPT:a. retinopathies. c. vascular fragility.b. sleep disorders. d. venous insufficiency.

7. Proanthocyanidins are members of a group of compoundscalled:a. alkaloids. c. flavonoids.b. cyanides. d. prostaglandins.

8. The three major types of tea (black, green, oolong) come from:a. the same species of tea plant. c. three different species of tea

plant.b. two different species of tea plant. d. more than a dozen different

species of teaplant.

9. Which type of tea has the greatest antioxidant activity comparedto the other two types?a. Black c. Oolongb. Green

10. One of the pharmacologic activities attributed to caffeineincludes increased release of:a. serotonin. c. dopamine.b. gamma aminobutyric acid. d. acetylcholine.


The Georgia Pharmacy JournalEditor: Jim Bracewell

[email protected]

Managing Editor & Designer:Kelly McLendon

[email protected]

The Georgia Pharmacy Journal® (GPJ) is the officialpublication of the Georgia Pharmacy Association, Inc. (GPhA).Copyright © 2009, Georgia Pharmacy Association, Inc. Allrights reserved. No part of this publication may be reproducedor transmitted in any form or by any means, electronic ormechanical including by photocopy, recording or informationstorage retrieval systems, without prior written permissionfrom the publisher and managing editor.

All views expressed in bylined articles are the opinions of theauthor and do not necessarily express the views or policies ofthe editors, officers or members of the Georgia PharmacyAssociation.

ARTICLES AND ARTWORKThose who are interested in writing for this publication areencouraged to request the official GPJ Guidelines for Writers.Artists or photographers wishing to submit artwork for use onthe cover should call, write or e-mail the editorial offices aslisted above.

SUBSCRIPTIONS AND CHANGE OF ADDRESSThe Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) isdistributed as a regular membership service, paid for throughallocation of membership dues. Subscription rate for non-members is $50.00 per year domestic and $10.00 per singlecopy; international rates $65.00 per year and $20.00 singlecopy. Subscriptions are not available for non-GPhA memberpharmacists licensed and practicing in Georgia.

The Georgia Pharmacy Journal® (GPJ) (ISSN 1075-6965) ispublished monthly by the GPhA, 50 Lenox Pointe NE, Atlanta,GA 30324. Periodicals postage paid at Atlanta, GA andadditional offices. POSTMASTER: Send address changes toThe Georgia Pharmacy Journal®, 50 Lenox Pointe, NE,

Atlanta, GA 30324.

ADVERTISINGAdvertising copy deadline and rates are available atwww.gpha.org upon request. All advertising and productionorders should be sent to the GPhA headquarters as listed

above.

GPhA HEADQUARTERS50 Lenox Pointe, NE

Atlanta, Georgia 30324

Office: 404.231.5074

Fax: 404.237.8435 www.gpha.org

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2008 - 2009 GPhA BOARD OF DIRECTORS

Name Position

Sharon Sherrer Chairman of the Board

Robert C. Bowles President

Eddie Madden President Elect

Dale Coker First Vice President

Jack Dunn Second Vice President

Jim Bracewell Executive Vice President/CEO

Burnis Breland State at Large

Hugh Chancy State at Large

Judy Gardner State at Large

Keith Herist State at Large

John McKinnon State at Large

Andy Rogers State at Large

Tommy Whitworth State at Large

Alex Tucker Region One President

Tony Singletary Region Two President

Renee Adamson Region Three President

Bill McLeer Region Four President

Shobhna Butler Region Five President

Bobby Moody Region Six President

Pam Marquess Region Seven President

Larry Batten Region Eight President

Alissa Rich Region Nine President

Chris Thurmond Region Ten President

Marshall Frost Region Eleven President

Ken Eiland Region Twelve President

Rusty Lee ACP Chairman

Liza Chapman AEP Chairman

Debbie Nowlin AHP Chairman

Tim Short AIP Chairman

Michelle Bishop APT Chairman

Hillary Volsteadt ASA Chairman

John T. Sherrer Foundation Chairman

Michael Farmer Insurance Trust Chairman

Pat McPherson Ex Officio - President, GA

Board of Pharmacy

Cynthia Pangburn Ex Officio - Chairman, GSHP

Gina Ryan EX Officio Mercer

Meagan Spencer Ex Officio Mercer ASP

Rusty Fetterman Ex Officio South

Rebecca Cubbedge Ex Officio South ASP

Brian Buck Ex Officio UGA

Walter Williams Ex Officio UGA ASP


Sid Anderson

[email protected]

Toll Free 1.888.871.5590

Georgia Pharmacy Journal®50 Lenox Pointe, N.E.

Atlanta, Georgia 30324

the georgia pharmacy journal: february 2009

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