VOLUME 41, NUMBER 3

President’s Message ………………………………………………………………….....………...2

Jason Babby, Pharm.D., BCPS, NYCSHP President

President-Elect’s Message …………...……………………………………..…….…..…….……..4

Karen Berger, Pharm.D., BCPS, BCCCP, NYCSHP President-Elect

An Overview of Pseudocholinesterase Deficiency ………………..................................................5

Matthew Li, Pharm.D. Candidate 2017, St. John’s University

Combatting Rising Drug Costs at the State and National Levels….…………………….………...8

Kimberly Lapierre, Pharm.D. Candidate 2017, St. John’s University

Member Spotlight…………………………………………………………...……………….……10

Joshua Rickard, Pharm.D., BCPS

NYCSHP New Practitioners Committee………………………………………………………….12

Harshal Shukla, Pharm.D., BCPS, Pavel Goriacko, Pharm.D., BCPS

Trivia Questions………………………………………………………………......…................….15

Photo Gallery…………………………………………………………………......…................…..17

VOLUME 41, NUMBER 3

President’s Message Jason Babby, Pharm.D., BCPS

NYCSHP has a record number of programs this

year. The three new committees (New Practitioners

Committee, Mentoring Committee, and Global

Health Initiative) that I formed have spearheaded

several new, meaningful, and exciting programs

for NYCSHP. This is a major accomplishment by

the individuals leading each of these committees!!

NYCSHP held its first ever medical

mission from Feb 27th-March 3rd at the

Santram Eye Hospital in Nadiad, Gujarat,

India. Kanika Ballani Lala, Chair of the

Global Health Initiative, spearheaded the

Medical Mission which was solely

conducted by NYCSHP. This is a historic

accomplishment for the society! We have

never in the history of NYCSHP provided

pharmacy services across the world!

Hundreds of patients received free blood

glucose tests, blood pressure readings,

education on diabetes, hypertension,

asthma, and medication counseling. I

would like to thank Dr. Kanika Ballani

Lala, Dr. Niki Patel, and Shivani Patel for

their dedication and hard work in

organizing the 1st medical mission! Thank

you to Dr. Harshal Shukla, Dr. Ekta

Yogi, Rima Jani, Phoebe Wong, Tu-Anh

Tran, and Maithili Patel who participated

and assisted with the preparation of the

medical mission!

The New Practitioner Committee (NPC),

co-chaired by Dr. Harshal Shukla and Dr.

Pavel Goriacko, has organized two CE

programs on Diabetics and Public Health

presented by New Practitioners for the

Spring! The NPC has organized over 8

programs this academic year!

Our Mentoring Committee, co-chaired by

Dr. Amber Johnson and Dr. Vickie Powell,

also planned an excellent opportunity to

educate students at Stuyvesant High School

in April on medication safety and the

profession of pharmacy. The Mentoring

Committee has organized a total of 4

programs this year!

We have continued work on providing programs

that would serve our technician members. For the

first time, our Student Relations Committee led by

Dr. Maabo Kludze-Forson organized a

CV/Interview workshop that was attended by both

Pharmacy students and Pharmacy technician

students. The pharmacy technician students loved

the program and were grateful for all the tips they

received. Maabo is currently working on

additional innovative initiatives with the State.

NYCSHP Public Relations Committee led by Dr.

Nikki Bhogal came together and used their

culinary expertise to host a dinner for families and

children at the Ronald McDonald House on the

evening of February 22nd. The Public Relations

Committee also organized a Toy-for-Tots event at

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our combined NYC and Royals CE Program in

December. This was the first time NYCSHP

participated in these two events! For the time in

decades, the Special Projects Committee organized

two Saturday CE Programs for the academic year.

The CE program on March 25th provided

pharmacists and pharmacy technician naloxone in

efforts to help those struggling with opioid and

heroin addiction. All 40 attendees became certified

to administer naloxone and received a free

naloxone rescue kit.

Thank you for your continued support this year!

Please see the calendar of events for the rest of the

impressive programs we have this year. Hope to

see you there! Feel free to email me at

Jason.Babby@mountsinai.org with any of your

ideas and suggestions.

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President-Elect’s Message

Karen Berger, Pharm.D., BCPS, BCCCP

It looks like March Madness has already come and gone. Whether you were rooting for your favorite college basketball team (go gators!) or a pharmacy student or resident who recently matched for a residency, a lot of exciting things were happening in March. Now that the “madness” has died down, I know that most of us are also looking forward to the warm weather soon coming our way. If you have not been able to make it to one of our NYCSHP events, I encourage you to check out some of the upcoming CE programs and networking dinners lined up for the spring. May events:

May 18: Networking Program Summer events:

NYCSHP/LISHP Mets Baseball game (Date TBD) While the fancy dinners are a major bonus, the real incentive to get involved is the fantastic networking that NYCSHP offers. There are few other opportunities to be in a room with such a diverse group of pharmacists and pharmacy students from all over the city. Please step outside of your comfort zone and say hello to someone

new. Exchange emails, keep in touch, share ideas, and develop your network. Also, let us know if you have ideas for future events. While the networking dinners are important, we are always looking to expand our nontraditional networking opportunities through events such as flag football, hiking, baseball games and other fun activities. I look forward to meeting you all at one of these events. If you are interested in getting involved or have any questions about NYCSHP, please feel free to email me at karenberger7@gmail.com.

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An Overview of Pseudocholinesterase Deficiency Matthew Li, Pharm.D. Candidate 2017, St. John’s University Preceptor: Maha Saad Pharm.D., CGP, BCPS, St. John’s University, Long Island Jewish Medical Center Introduction Pseudocholinesterase (PChE) deficiency is an inherited or acquired condition that results in abnormally slow metabolic degradation of exogenous choline ester drugs, such as succinylcholine and mivacurium leading to prolonged neuromuscular paralysis and apnea.1 PChE deficiency is also acquired when certain physiologic, drug-induced, and genetic factors can lower pseudocholinesterase activity. Patients can live their life with such deficiency and not experience any symptoms until exposed to succinylcholine or mivacurium. Pseudocholinesterase, (also known as butyrylcholinesterase, plasma cholinesterase, serum cholinesterase, and nonspecific cholinesterase) is an enzyme that is synthesized in the liver and circulates in the plasma; it is responsible for metabolizing succinylcholine, mivacurium (no longer available in the United States), and ester local anesthetics via hydrolysis of ester bonds.2,3 Succinylcholine is a rapid-acting neuromuscular blocker used as an adjunct to general anesthesia, to facilitate tracheal intubation, and to skeletal muscle relaxation during surgery or mechanical ventilation. It is preferred for rapid sequence induction in patients with a difficult airway because of its rapid onset (<60 seconds) and brief duration of action (5 to 10 minutes).4 Drug-Induced Pseudocholinesterase Deficiency There are numerous drugs that may lead to decreases in PChE activity. There have been case reports noting reduction in PChE after administration of cyclophosphamide, acetylcholinesterase inhibitors (neostigmine, physostigmine, pyridostigmine), and metoclopramide.5,6,7 Oral contraceptives have been shown to cause steroid-induced depression of the liver’s ability to synthesize or secrete PChE into the circulation.8 Cocaine has been linked to a decrease in the availability of PChE in both life-threatening and non-life-threatening toxicity.9

It is important to note that although offending agents decrease PChE activity, the levels of PChE could still be within normal range.10 This decrease in PChE activity becomes clinically significant when coupled with a genetic disorder or acquired condition affecting PChE. It has been speculated that a decrease of at least 50% in PChE is necessary to produce clinically significant prolonged neuromuscular blockade.11 Acquired Conditions that Lead to Pseudocholinesterase Deficiency PChE is a glycoprotein enzyme that is synthesized in the liver and circulates in the plasma. There are many conditions and disease states that have demonstrated a lowering in PChE levels secondary to changes in liver function. Many types of cancer (hepatic, breast, lung, gastrointestinal, genitourinary) have been tied with a reduction in PChE levels correlating with the site of the primary lesion and the degree of spread; hepatic carcinomas have demonstrated the greatest degree of PChE reduction.12 Malnutrition causes altered synthesis of proteins and enzymes, including PChE.13 Burn patients suffer an initial loss of PChE due to transcapillary losses and prolonged decreases due to hepatic depression of synthesis or release.14 The etiology for decreased PChE levels in diseases states such as renal disease, pregnancy, cardiopulmonary bypass patients, and leprosy is unknown.15,16,17 As with drug-induced PChE deficiency, it is speculated that these acquired conditions alone are not sufficient at producing a clinically significant decrease in PChE levels unless coupled with another factor such as a genetic disorder or offending agent.

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Genetics and Testing for Pseudocholinesterase Deficiency PChE deficiency is inherited in an autosomal recessive pattern; parents of an individual having one copy of the altered gene in each cell that can pass the gene mutation to their children. In some cases, carriers of butyrylcholinesterase (BCHE) gene mutations take longer than usual to clear choline ester drugs from the body, but not as long as those with two copies of the altered gene in each cell.19

A number of allelic mutations in the pseudocholinesterase gene have been linked to PChE deficiency. Such mutations include point mutations resulting in abnormal enzyme structure and function and frameshift or stop codon mutations resulting in absent enzyme synthesis.1 The geographical prevalence of homozygotes varies around 1:100,000 in people of European descent, but up to 1:25 in the Inuits (Eskimo) and Vysya community (Andhra Pradesh, India).20 There are no physical exam findings that indicate a deficiency of PChE. It is a clinically silent condition unless the patient is exposed to diseases, medications, or compounds that can induce symptoms of prolonged paralysis of muscles.21 The dibucaine inhibition test can be performed to identify patients who are homozygous for an atypical BCHE gene. In normal individuals, dibucaine will almost completely inhibit PChE activity (70-90% inhibition). Individuals who are homozygous for a mutation in the BCHE gene will generally have low levels of PChE which are minimally inhibited by dibucaine (0%-20% inhibition).21 The reference values for PChE are shown in table 1.

Table 1. Reference Values for Pseudocholinesterase Levels22

Patient Population Pseudocholinesterase levels

Males 3,100-6,500 U/L

Females 18-49 years old 1,800 – 6,600 U/L

Females ≥ 50 years old 2,500 – 6,800 U/L

Management Patients with PChE deficiency may present with prolonged neuromuscular blockade, potentially lasting up to 8 hours.18 Neuromuscular response can be evaluated with clinical assessment (maintenance of patient-ventilator synchrony and prevention of patient movement) with train-of-four monitoring. In numerous case reports, patients with PChE deficiency exhibited 0/4 twitch response following administration of succinylcholine.21, 23 There is no established cure for PChE deficiency. In the event of prolonged neuromuscular blockade secondary to PChE deficiency, the current standard of care is to provide reassurance, additional sedation, and continued mechanical ventilation until the patient can recover spontaneously and unaided.23

There is insufficient data supporting alternative interventions such as administering whole blood, fresh frozen plasma, and human pseudocholinesterase.2 When PChE deficiency is suspected, a serum PChE level should be drawn and a dibucaine inhibition test should be performed at least 48 hours after exposure to a neuromuscular blocker or anticholinergic agent.23

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Summary Pseudocholinesterase deficiency is a rare genetic and/or acquired condition in which the metabolism of succinylcholine, mivacurium, and ester local anesthetics is impaired. The predominant feature of PChE deficiency is prolonged periods of apnea and paralysis. There are certain acquired conditions, offending agents, and genetic mutations that can cause PChE deficiency. Diagnosis can be confirmed by performing the dibucaine inhibition test. There is no cure for PChE deficiency; the current standard of care is to allow the patient to recover spontaneously and unaided while providing supportive care.

References 1. Soliday FK, Conley YP, Henker R. Pseudocholinesterase deficiency: a comprehensive review of genetic, acquired, and drug influences. AANA J. 2010; 78(4):313-20. 2. Kaufman SE, Donnell RW, Aiken DC, et al. Prolonged neuromuscular paralysis following rapid-sequence intubation with succinylcholine. Ann Pharmacother. 2011; 45(4):e21. 3. Pedersen NA, Jensen FS. Clinical importance of plasma cholinesterase for the anesthetist. Ann Acad Med Singapore. 1994; 23(6 Suppl):120-4. 4. Naguib M, Samarkandi AH, El-Din ME, et al. The dose of succinylcholine required for excellent endotracheal intubating conditions. Anesth Analg. 2006; 102(1):151-5. 5. Koseoglu V, Chiang J, Chan KW. Acquired pseudocholinesterase deficiency after high-dose cyclophosphamide. Bone Marrow Transplant. 1999; 24(12):1367-8. 6. Ramirez JG, Sprung J, Keegan MT, et al. Neostigmine-induced prolonged neuromuscular blockade in a patient with atypical pseudocholinesterase. J Clin Anesth. 2005; 17(3):221-4. 7. Kao YJ, Turner DR. Prolongation of succinylcholine block by metoclopramide. Anesthesiology. 1989; 70(6):905-8. 8. Robertson GS. Serum protein and cholinesterase changes in association with contraceptive pills. Lancet. 1967; 1(7484):232-5. 9. Hoffman RS, Henry GC, Howland MA, et al. Association between life-threatening cocaine toxicity and plasma cholinesterase activity. Ann Emerg Med. 1992; 21(3):247-53. 10. Motamed C, Fanen P, Feiss P, et al. Dose-response effect of serum butyrylcholinesterase activity after clinical doses of pancuronium. Eur J Clin Pharmacol. 2008; 64(11):1043-5. 11. Whittaker M. Plasma cholinesterase variants and the anaesthetist. Anaesthesia.1980; 35(2):174-97. 12. Kaniaris P, Fassoulaki A, Liarmakopoulou K, et al. Serum cholinesterase levels in patients with cancer. Anesth Analg. 1979; 58(2):82-4. 13. Barclay GP. Pseudocholinesterase activity as a guide to prognosis in malnutrition. Am J Clin Pathol. 1973; 59(5):712-6. 14. Viby-Mogensen J, Hanel HK, Hansen E, et al. Serum cholinesterase activity in burned patients. I: biochemical findings. Acta Anaesthesiol Scand.1975; 19(3):159-68. 15. Simon NM, Del Greco F, Dietz AA, Rubinstein HM. Serum cholinesterase deficiency in renal failure. Trans Am Soc Artif Intern Organs. 1969; 15:328-32. 16. Rump AF, Schierholz J, Biederbick W, et al. Pseudocholinesterase-activity reduction during cardiopulmonary bypass: the role of dilutional processes and pharmacological agents. Gen Pharmacol. 1999; 32(1):65-9. 17. Navarrete JI, Lisker R, Pérez-Briceńo R. Serum atypical pseudocholinesterase and leprosy. Int J Dermatol. 1979; 18(10):822-3. 18. Valle AM, Radić Z, Rana BK, et al. The cholinesterases: analysis by pharmacogenomics in man. Chem Biol Interact.2008; 175(1-3):343-5. 19. Pseudocholinesterase deficiency - Genetics Home Reference. U.S National Library of Medicine. https://ghr.nlm.nih.gov/condition/pseudocholinesterase-deficiency. Accessed November 11, 2016. 20. Pandit JJ, Gopa S, Arora J. A hypothesis to explain the high prevalence of pseudo-cholinesterase deficiency in specific population groups. Eur JAnaesthesiol. 2011; 28(8):550-2. 21. Leadingham CL. A case of pseudocholinesterase deficiency in the PACU. J Perianesth Nurs. 2007; 22(4):265-71; 22. Pseudocholinesterase, Total, Serum. Mayo Clinic Mayo Medical Laboratories. http://www.mayomedicallaboratories.com/test-catalog/clinical and interpretive/8518. Accessed November 11, 2016. 23. ARUP National Reference Laboratory. Pseudocholinesterase, dibucaine inhibition. http://www.aruplab.com/guides/ug/tests/0020159. Accessed November 11, 2016.

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Combatting Rising Drug Costs at the State and National Levels

Kimberly Lapierre, Pharm.D. Candidate 2017, St. John’s University Preceptor: Khusbu Patel, Pharm.D., St. John’s University In the past year, a variety of prescription drugs have been subjected to extreme price hikes as pharmaceutical companies have had the ability to increase drug prices to maximize profit with limited surveillance. A great number of patients have been unable to access life-saving medications and as a result the pharmaceutical industry has garnered national scrutiny. Legislators, at both the state and national levels, have introduced drug pricing transparency bills to attempt to combat this rapidly escalating economic battle. However, it is yet to be determined whether legislation can control drug price increases.

The turn of the millennium not only brought advancing technology and healthcare, but also specialty and generic drugs with staggering prices. Specialty drug companies have capitalized on patent exclusivity, lack of alternatives, and invaluable market niches to increase prices without a great loss of consumers. Many of these specialty drugs are biologics and therefore are more expensive to manufacture. For example, Gleevec® (imatinib), a tyrosine kinase inhibitor, originally priced at $31,000 for a year’s supply, can now be purchased for four times that amount.1 Ten years later, novel therapies for hepatitis C can provide a cure at a cost of approximately $84,000 for a treatment course, however the alternative, liver transplant, can cost more than $500,000.2 According to the UnitedHealth Center for Health Reform & Modernization, spending on specialty drugs in 2012 in the United States was about $87 billion which could quadruple by 2020, reaching about $400 billion, or 9.1 percent of national health spending.3

Furthermore, generic manufacturers have been able to increase drug costs due to lack of competition. For example, Turning Pharmaceuticals former CEO, Martin Shekel, purchased the rights to Daraprim® (pyrimethamine), an antimalarial on the market since January 1953 that is also used for Toxoplasmosis and Pneumocystis pneumonia, and then increased the price from $13.50 to $750 a pill; a 5000% increase.4 Of late, Mylan has received negative press for increasing the cost of EpiPen®. However, instead of increasing the cost of EpiPen overnight, the company has steadily increased the price by 450% overall in growing increments since 2007.5 From May 2015 to May 2016 the price of EpiPen® was increased by 32% compared to a 5% price increase from 2008 to 2009.6,7 Millions of Americans depend on EpiPen® in the event of an allergic reaction thus injecting members of Congress and state legislators into what is now a national conversation. On September 10, 2015, Bernie Sanders introduced the Prescription Drug Affordability Act of 2015 to the Senate. The bill, which was read twice and referred to the Committee on Finance, must receive a stamp of approval from the Senate, House, and President before it becomes law. The Act is a bill to ensure greater affordability of prescription drugs, which amends titles XVlll (Medicare) and XIX (Medicaid) of the Social Security Act as well as the Federal Food, Drug, and Cosmetic Act and the Federal Trade Commission Act .8 This Act will require negotiation to lower prices for Medicare Part D drugs, require rebates for low-income patients that can also be used for generic drugs, adjust market exclusivity laws, and allow drugs to be imported from Canada. The amount of time until the bill becomes law is unknown, thus state governments have also introduced bills.

As of August 2016, thirteen states had proposed bills that would force pharmaceutical companies to justify their pricing decisions through releasing cost information. Ideally, this would result in drug companies lowering their prices to avoid being scrutinized for their profits. Some states like Vermont have been

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successful with pushing through transparency bills. Conversely, California state legislators pulled their bill due to amendments by the Assembly Appropriations Committee which resulted in a bill unable to accomplish the original goal.9,10 Opponents argue that transparency bills are not the best way to combat extreme prices; instead, drug companies should be required to follow set prices based off a state assessment of the value of the medication.9 The equivalent bill for New York State, Senate Bill S5338A, would require companies to disclose research and development costs for drugs with a wholesale acquisition cost over $10,000 per patient per year or per course of treatment.11 As of January 20, 2016 the bill had been amended and referred back to the Health Committee.12

It is evident that both national and state legislators are actively working to improve medication pricing. Whether these bills will have a large enough impact on pharmaceutical companies to lower prices will only be evident if the proposed changes to increase regulation of medication prices become law. With any luck, inflated prices will drop quickly and millions of American can have access to the life-saving medication they need without further barriers.

References: 1. Szabo L. A timeline of eye-popping drug prices. USA Today. August 27, 2016. http://www.usatoday.com/story/news/2016/08/25/timeline-eye-popping-drug-prices/89335852/. Accessed September 7, 2016. 2. Financing a transplant. UNOS Transplant Living. https://transplantliving.org/before-the-transplant/financing-a-transplant/the-costs/. Accessed October 2, 2016 3.UnitedHealth Group. The growth of specialty pharmacy: Current trends and future opportunities, (2014). http://www.unitedhealthgroup.com/~/media/uhg/pdf/2014/unh-the-growth-of-specialty-pharmacy.ashx. Accessed October 2, 2016. 4.Timmerman L. A Timeline of the Turing Pharma controversy. Forbes. September 23, 2015. http://www.forbes.com/sites/luketimmerman/2015/09/23/a-timeline-of-the-turing-pharma-controversy/#5aaeed967b94. Accessed September 7, 2016. 5.Cha AE. U.S. Lawmakers demand investigation of $100 price hike of lifesaving EpiPens. Washington Post. August 23, 2016. https://www.washingtonpost.com/news/to-your-health/wp/2016/08/23/u-s-lawmakers-demand-investigation-of-100-price-hike-of-life-saving-epipens/. Accessed September 7, 2016. 6. Popken B. Mylan CEO salary rose by 600 percent as EpiPen price rose 400 percent. August 23, 2016. http://www.nbcnews.com/business/consumer/mylan-execs-gave-themselves-raises-they-hiked-epipen-prices-n636591. Accessed October 2, 2016. 7. Mangan D. This chart shows why everyone’s angry about soaring price of lifesaving EpiPen. Biotech and Pharmaceuticals. August 23, 2016. http://www.cnbc.com/2016/08/23/this-chart-shows-you-why-a-lot-of-people-are-angry-about-the-price-of-epipen.html. Accessed October 2, 2016. 8.Prescription Drug Affordability Act of 2015, S.2023 S. 2023 - 114th congress (2015-2016): Prescription drug affordability act of 2015 (2015). 9.Silverman E. Laws to expose drug pricing strategies probably won’t work. Stat. http://www.statnews.com/pharmalot/2016/08/16/drug-pricing-laws/. Published 2016. Accessed September 7, 2016. 10.Ibarra AB. California lawmaker pulls plug on drug price transparency bill. Kaiser Health News. http://khn.org/news/california-lawmaker-pulls-plug-on-drug-price-transparency-bill/. Published 2016. Accessed September 7, 2016. 11.Sarpatwari A, Avorn J, Kesselheim AS. State initiatives to control medication costs — can transparency legislation help? New England Journal of Medicine. 2016;374(24):2301–2304. doi:10.1056/nejmp1605100. 12.Senate Bill S5338A, Senate, (2015). https://www.nysenate.gov/legislation/bills/2015/s5338. Accessed September 7, 2016.

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MEMBER SPOTLIGHT Joshua Rickard, Pharm.D., BCPS

Assistant Professor – Industry Professional St. John’s University, New York, NY

My Story:

At the age of 16, I began working as a front store cashier for CVS Pharmacy. From this experience, I

developed a strong desire to learn all of the ins and outs of a pharmacist’s role within the healthcare field, and

it was at this time that my interest in the world of pharmacy was piqued.

In the fall of 2008, I was welcomed into pre-pharmacy program at the University of South Carolina. I began my

professional courses at the South Carolina College of Pharmacy – University of South Carolina Campus In 2010,

and four years later, I received a Doctor of Pharmacy degree.

I went on to pursue a PGY-1 Pharmacy Practice Residency at the James J. Peters VA Medical Center in the

Bronx, allowing for a radical change of scenery following my move from South Carolina to New York City. I

then made the cross country trek once again relocating to Salt Lake City, UT to complete my PGY-2

Ambulatory Care Residency at Intermountain Healthcare. I returned to New York in July of 2016 and began my

career at St. John’s University as an Assistant Professor – Industry Professional working in the Ambulatory Care

setting, whereby I am afforded the opportunity to precept students completing their 4th year of professional

studies in pharmacy.

Facility:

St. John’s University is a Catholic, Vincentian, Metropolitan, and Global university. The mission of St. John’s is

one of academic excellence, service, and commitment to lifelong learning, which can be seen through the

actions and values of the College of Pharmacy’s faculty members and students. Our students receive practical

training in diverse and often disadvantaged areas within the New York City metropolitan area. Pharmacy

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students also have the opportunity to study abroad in countries such as Italy, France, and Spain. Consistent

with my role as an Assistant Professor-Industry Professional, I precept students on ambulatory care clinical

rotations at Queens Hospital Center (QHC), a member of the NYC Health + Hospitals integrated health care

system. QHC effectively serves the culturally diverse areas of central and southeastern Queens, and addresses

the needs of its patients through available ambulatory care clinics specializing in adult and pediatric medicine,

psychiatry, diabetes etc.

Significant Projects:

I am working on publishing a manuscript detailing the recommended monitoring adherence rates for

antiarrhythmic drugs, specifically amiodarone and dofetilide. The results of this study identify a potential gap

in the proper monitoring of these antiarrhythmics, a gap that ambulatory care pharmacists are equipped to

fill. I am also currently working on a cross-departmental study at St. John’s University with two students and

faculty from the Department of Public Health and Department of Computer Science to create a mobile game

that will educate family and caregivers of patients with diabetes.

Advice for New Practitioners:

My advice to new practitioners is to pursue opportunities in unique practice settings, whether it is through

residency training, experiential rotations, or volunteer services (i.e. travel to new locations; work with diverse

patient populations; pursue a rotation in an unfamiliar healthcare setting etc.). As a student and resident, I

had the opportunity to practice in many different locations including South Carolina, Ohio, Arizona, Hawaii,

New York, and Utah. Each state and practice setting is different in regards to laws and regulations, patient

population, and overall pharmacy practice. I believe these experiences have made me a more empathetic,

inquisitive, and a well-rounded pharmacist.

Value of NYCSHP:

I joined NYCSHP at the beginning of my PGY-1 year on the recommendation of Sasha Falbaum, which I have

never regretted! NYCSHP has given me so many invaluable opportunities to interact with and learn from a

vast number of pharmacists, students, and technicians within a variety of practice settings across the city,

which is essential for every new pharmacist practicing in New York City.

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NYCSHP New Practitioners Committee

Harshal Shukla, Pharm.D., BCPS, Pavel Goriacko, Pharm.D., MPH

In August 2016, New York City Society of Health System Pharmacists (NYCSHP) introduced the New

Practitioners Committee (NPC) to support new practitioners’ transitions into real world practice and kindle

lifelong involvement in professional organizations. The committee was co-chaired by two new practitioners’

members, Dr. Harshal Shukla and Dr. Pavel Goriacko.

The committee targeted pharmacists within the first five years of practice post-graduation with goal of

providing opportunities for professional collaboration and development, as well as to leverage mentorship

and support from seasoned pharmacy practitioners.

The NPC consists of pharmacy residents, clinical pharmacists, and staff pharmacists. Events and programs

were designed to specifically address the educational and informational needs of new practitioners identified

through an online survey. The committee goals were to provide a mix of leadership development programs,

continuing education programs, community service events, and social events.

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A total of 5 networking programs, 2 continuing educations programs, and 1 community service event were

organized. An NPC survey was conducted early in September 2016 and results showed leadership and

professional development programs were rated with highest interest levels. A networking leadership program

was organized and the event attendance consisted of 60% residents, 30% clinical pharmacists, and 10% staff

pharmacists. Social media outlets (e.g. Facebook, Instagram) were heavily utilized in member communication.

The majority of new practitioners agreed that the programs addressed their needs as a new practitioner. Four

of the NPC members sought leadership positions within NYCSHP.

A focused committee providing guided programs to new practitioners allows for greater involvement in the

chapter. Networking programs targeting new practitioners can provide an opportunity for professional

development and collaboration with season practitioners of the society. Embracing social media

communication outlets provides an effective way of reaching more new practitioners in the society. NPC

should serve as a model for facilitating greater involvement of new members in the NYSCHP programs and

leadership.

Have an Instagram? Follow us @nycshpnewpractitioners

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CALL FOR PAPERS Have you wanted to publish, but never had a chance?

We are looking for articles in all areas of pharmacy

practice!

Please submit your publications to the bulletin editors: Sasha Falbaum alexandra11229@gmail.com

Alla Khaytin alla_melamed@yahoo.com William Olsufka williamolsufka@gmail.com

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NYCSHP at the 2017 House of Delegates

1. Which one of the Founding Fathers was a pharmacist?

2. Which three popular beverages were created by a pharmacist?

3. Which medication is the most commonly prescribed in US?

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NYCSHP Board Members Contact Information

President Jason Babby jason.babby@mountsinai.org

President-Elect Karen Berger kab9098@nyp.org

Immediate Past-President Yi Guo yiguo@montefiore.org

Secretary Charrai Byrd chb9050@nyp.org

Treasurer Marie DiMicco dimicco.marie@gmail.com

Directors-at-Large

Constitution and Bylaws, Public Relations, Special Projects

Nikki Bhogal nbhogal@chpnet.org

Student Relations, Legislative Affairs, Supportive Personnel

Maabo Kludze-Forson mkludze@gnyha.org

Installation Dinner, Membership, Industry Relations

Zane Last zlast@sbhny.org

Bulletin Editors

Sasha Falbaum alexandra11229@gmail.com

Alla Khaytin alla_melamed@yahoo.com

William Olsufka williamolsufka@gmail.com

Committee Chairs/Members

Constitution and By-Laws Amisha Leimbach (Chair), Tamara Yunusova, Kristin Linder, Sulema Barron, Kanika Ballani, Harshal Shukla, Alina Levitsky

Public Relations Kristin Linder (Chair), George Falbaum, Khusbu Patel, Pinkal Patel, Karin Yamazaki, Andrew Smith, Grace E. Lee, Zachary Piracha, Tamara Yunusova, Kristin Linder, Tram Thai, William Olsufka

Special Projects Alina Levitsky (Chair), Tamara Yunusova, Daryl Paris, Denis Adamchuk , Tram Thai, William Olsufka, Kristin Linder

Student Relations Khusbu Patel, Julia Sessa, Stephen Farley, Hina Ghani, Zachary Piracha, Melissa Santibanez

Legislative Affairs Stephen Keelen

Supportive Personnel Marina Petratos

Installation Program Fawad Piracha, Hina Ghani, Zachary Piracha, Todd Larson, Sasha Falbaum

Industry Relations Colleen Kim, Fawad Piracha, Hina Ghani, Zach Piracha

Grant Writing Evangelina Berrios-Colon

Social Media Coordinator Elsie Wong

Historian Johnny Hon

Community Outreach George Falbaum

Global Health Initiative Kanika Ballani

Mentoring Vickie Powell, Amber Johnson

New Practitioner Committee Harshal Shukla, Pavel Goriacko

Membership Yasmin Saafan, Karin Yamazaki, Liliana Argento, Monica Sorio, Sulema Barron, Zachary Piracha, Hina Ghani

Liaisons

State Liaisons Monica Mehta, Joe Pinto

Faculty Liaisons Mary Choy (Touro College of Pharmacy), Khusbu Patel (St. John’s University), Kristin Linder, Priyasha Uppal (Long Island University)

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VOLUME 41, NUMBER 3

CE PROGRAMS AND NETWORKING EVENTS

DECEMBER NETWORKING WITH ROYALS

Location: Scaletta Ristaurante

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VOLUME 41, NUMBER 3

JANUARY CE PROGRAM

Location: Club A Steakhouse

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VOLUME 41, NUMBER 3

MENTORING COMMITTEE EVENTS

Location: Harlem Renaissance High School

Location: Stuyvesant High School

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VOLUME 41, NUMBER 3

NYCSHP MEDICAL MISSION

Nadiad, India

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