1. DIRC/OPA News
DIRC Provides Clinical Support to Ontario
Pharmacists to Support Professional Services
To support the launch of professional services in Ontario, DIRC is now
providing support to pharmacists in implementing the Meds
Check medication review program. This support is funded by the
Ministry of Health and Long-Term and is available to all Ontario
pharmacists. DIRC will provide clinical support to help pharmacists
implement medication review services. (Note: If you are not a
DIRC subscriber, services provided by DIRC will be limited to support
in implementing the protocol and program only - this service does not replace your regular drug
information service subscription.)
changes were made to the Personal
Medication Review Forms based on pharmacist feedback and ease of
implementation to practice:
Form 1: Patient Background Form
· Removed Doctor field, Doctor # field, Health Card #
field, Reason for Review column
categories, and two Background Information questions
· Added Meds Check Patient Criteria
Form 2: Patient Medication History Form
· Added Patient Adherence column to Table 1 and Table
· Renamed column I in Table 2 as “Expiry Date”
Form 3: Medication Review: Action Plan
· Removed Health Card Number and Pharmacist Signature
Form 4: Personal Medication Record
· Removed Stop Date column and Updated field
· Switched Medication Brand (Generic) column with
Start Date column
· Renamed Family or Primary Physician as “Primary
· Added Date of Last Meds Check field
Form 5: Physician Letter
· Simplified information required on letter
· Removed Patient Information box and Contact Number
· Reworded first check box as “No medication
· Reworded phrasing to state “this service is covered
by the provincial drug plan”
Data Collection Form
· Modified to reflect changes in forms
· Elaborated on potential issues that could be
identified in columns of Form 2
For more information on pharmacist professional services in Ontario,
visit the new OntarioRph.ca website.
For rapid access to DIRC's tools and protocol, visit the DIRC website. For clinical support,
DIRC by email or by phone at (800)
268-8058 and press "2" at the first prompt.
Obesity Certificate Program
The Canadian Obesity Network (CON) and OPA have partnered to bring
pharmacists a one-day obesity education program that will be held in
various locations nationally. Delivered in a combination of
lecture and case-based learning styles, pharmacists will gain a better
understanding of obesity and be well-equipped to provide practical
information on the prevention and management to their patients.
Topics covered will include an introduction to obesity,
pathophysiology, evaluation, and various pharmacological and
non-pharmacological treatment strategies that follow the new 2006
Canadian Clinical Practice Guidelines on the Management and Prevention
be added to our notification list for more information as it becomes
Call for Abstracts: OPA Annual Conference:
September 7-8, 2007
Have you developed an innovative program, service or intervention that
is relevant to practising pharmacists? Are you interested in profiling
yourself, your pharmacy team and pharmacy while building your CV?
Consider submitting an abstract for consideration for the 2007 OPA
conference. Both poster presentations and oral
presentations will be accepted. Abstracts may be submitted online at
www.opatoday.com up until May 15, 2007.
Notification of accepted
submissions will take place by June 29, 2007. Full details are
available on the OPA
DIRC Speaker Registry
Do you have expertise in a particular area of practice?
Are you interested in public speaking?
Do you have innovative ideas for CE topics?
DIRC is seeking speakers on various educational topics for
presentations across Canada! If you answered "Yes" to these questions
please click on the link and
apply to become part of the Drug
Information and Research Centre (DIRC)'s speaker registry.
pleased to announce that Shao Lee,
BScPhm, MBA is joining the DIRC team as a
full-time Drug Information Pharmacist. Shao's work experience has
included retail pharmacy manager, business research analyst/consultant
positions, and a number of roles at Janssen-Ortho, including marketing
associate, medical sales representative, product specialist, and most
recently, CHE business manager (pain/GI). Shao also continues to work
part-time in community pharmacy.
Shao joins a team of skilled health professionals at DIRC dedicated to
improving the appropriate use of medications. For more information,
visit DIRC staff profiles.
Adverse Reaction Newsletter
In the April
Quetiapine - Pancreatitis and
There have been 9 and 11 reported cases of pancreatitis
thrombocytopenia, respectively, possibly associated with quetiapine
use. These cases have been reported between the end of December 1997
until October 2006. These two adverse reactions are not listed in the
Canadian product monograph.
Telithromycin - Toxic
A woman who completed a 12 day course of telithromycin was
diagnosed with toxic
epidermal necrolysis after starting a second course two days later.
She first experienced a rash
which progressed to reddening of the eyes and skin as well as swelling
of the face and lips. Eventually, the skin was peeling from her head to
her thighs, involving more than 50% of her body. Acute respiratory
distress syndrome ensued, requiring intubation. The patient recovered
after a 4 week hospital stay and was discharged with scars on her
body and face.
Bitter Orange/Synephrine -
Cardiovascular Adverse Reactions
Products containing synephrine, an α1-agonist, are
not authorized for sale in Canada. Products containing synephrine are
used for weight loss. There have been 31 reported cases of cardiovascular
adverse events possibly associated with the use of
bitter orange or synephrine from January 1998 until October 2006
including 1 case of myocardial infarction. Certain patients with
predisposing medical conditions should not use products containing this
agent. These populations include individuals with thyroid
disease, heart conditions, hypertension, CNS disorders, glaucoma,
pheochromocytoma or enlarged prostate. Individuals taking thyroid
hormones, monoamine oxidase inhibitors or medications to control heart
rate or blood pressure should also not consume these products.
3. Health Canada
Warnings and Advisories
Erythropoeisis-stimulating agents, darbepoetin (Araesp) and epoetin alfa (Eprex), should not be
prescribed for cancer patients who do
not have anemia associated with chemotherapy.
Consumers are advised not to use FiberChoice plus Multivitamins, a
fibre supplement originating from the United States. This product contains
an undeclared ingredient, fish gelatin. This may provoke an
allergic response in individuals with allergies to seafood.
Consumers are advised not to use Eden Herbal Formulations Serenity Pills II,
a herbal sleep supplement. This product has been
contain the benzodiazepine estazolam. The product is not
authorized for sale in Canada but was previously distributed in Alberta.
Consumers are advised not to use Lanmei Keili Ji, a cold, flu and
cough product. This product
originates from China and has been found to contain the antidiabetic
agent gliclazide. This product is not authorized for sale in Canada
but may have been purchased abroad or
through the internet.
Consumers are advised not to use V.MAX, Rhino Max (Rhino V Max). This product
originates from the United States and has been found to
contain aminotadalafil, an analogue of tadalafil. This product is
not authorized for sale in Canada but may have been purchased abroad or
through the internet.
Consumers are advised that certain lots of Salivart Oral Moisturizer may be contaminated
with mould or yeast. Only one lot of the affected product has been
distributed in Canada. The lot number is 06BB002, with an expiration
date of 06-08.
Health Canada is reviewing the association
between the use of pergolide
(Permax) and cardiac
valvulopathy following its withdrawal from the market in the United
States. Two studies published in January 2007 concerning the
association of the use of
pergolide with the risk of cardiac valve abnormalities are being
reviewed by Health Canada.
There have been several cases of self
harm, abnormal or suicidal behaviour reported in pediatric patients
taking oseltamivir (Tamiflu)
in Japan. No
such cases have been reported in Canada. The causailty between the use
of the drug and self harm has not been established. Complications of
influenza may lead to changes in mental state and contribute to this
Consumers are advised not to use the natural
health product XOX For Men and Vigorect Oral Gel Shooter. These
products has been found to contain tadalafil. These
products are not authorized for sale in Canada however they may have
been imported and found on the Canadian market.
There have been reports of acute
renal failure that may be possibly associated with the use of deferasirox (Exjade). Serum
creatinine should be assessed twice before patients receive treatment
deferasirox. Serum creatinine should be monitored weekly for the first
month after initiating treatment and monthly thereafter. There have
also been cases of cytopenia reported in patients treated with
deferasirox. The association between the occurrence of cytopenia and
the use of deferasirox is unknown.
Consumers are advised not to use Miaozi
Slimming Capsules or Lexscl Fat Rapid Loss capsules.
These products are not authorized for sale in Canada but may have been
purchased abroad or
through the internet. Both products have been found to contain sibutramine.
Consumers are advised not to use certain lots of ReNu MultiPlus contact lens solution
manufactured by Bausch and Lomb. Affected lots are designated GC6038
and GC6052. The Drug Identification Number (DIN) for this product is
02230538. The affected lots have been found to contain higher levels of iron. This
may lead to increased risk of infection and decreased product
effectiveness as a contact lens cleanser.
4. Online Publications
The March 2007 issue
of Canadian Family Physician is available
and includes articles on:
Safety of rheumatoid
arthritis medications in
Do derivatives of
panax ginseng prevent
15, 2007 issue of American Family
available and includes articles on:
Treatment of Impetigo
The April 10th
issue of CMAJ is available:
Management of hypothyroidism during
the 2006 Canadian clinical practice guidelines on the management and
prevention of obesity in adults and children
clinical practice Guidelines on the management and
prevention of obesity in adults and children
its etiology, effects and treatment
Teaming Up For Musculoskeletal
(MSK) Care: An Interprofessional Approach
The two-day conference will
provide the participant with an enhanced learning experience that is
relevant to current clinical practice and will assist in developing an
interprofessional network. The program is developed through the Centre
for Effective Practice at the Department of Family & Community
Medicine, University of Toronto, in conjunction with
university-appointed faculty. The unique needs of primary care
practitioners will be central to the course curriculum so that the
common educational gaps in MSK knowledge can be bridged. For more
information please email email@example.com,
call 416.619.0089 or download
the conference brochure at
(located on the homepage).
Dates: June 8 & 9, 2007
Location: Toronto Marriott Downtown Eaton Centre Hotel (525 Bay
6. DIRC Values
DIRC strives for 100% client
every call or inquiry. If you have any general questions or comments
DIRC's services, please
contact Mandy De Jong, Senior
Manager, Quality Assurance (acting), at (416) 385-2440 x 2205, or Scott
Gavura, DIRC Director, at (416)
385-2440 x 2222.
If you have received information via fax,
you may fill out a satisfaction survey at
the DIRC website (have your
number from the fax cover sheet handy).
Your feedback on the
bulletin and on DIRC's services is welcomed.
Mandy De Jong, Senior
Manager, Quality Assurance (acting)
Leam Tang, Drug Information Pharmacist
Telephone: (800) 268-8058 or (416) 385-DIRC
Fax: (416) 385-2442
375 University Avenue, Suite 800