Tel: 614/466-4143          Fax: 614/752-4836           Email: exec@bop.state.oh.us           Web: www.pharmacy.ohio.gov




~~ FEBRUARY 2004 ~~



The Ohio State Board of Pharmacy News is published by the Ohio State Board of Pharmacy and the National Association of Boards of Pharmacy Foundation, Inc. to promote voluntary compliance of pharmacy and drug law.  The opinions and views expressed in this publication do not necessarily reflect the official views, opinions, or policies of the Foundation or the Board unless expressly so stated.

William T. Winsley, MS, RPh - State News Editor

Carmen A. Catizone, MS, RPh, DPh - National News Editor & Executive Editor

Reneeta C. "Rene" Renganathan - Editorial Manager



State News Section



New Web Site Address for Pharmacy Board

Make a note of the Ohio State Board of Pharmacy’s new Web site address: www.pharmacy.ohio.gov.  If you have us on your favorites list, please be sure to change our address.


Continuing Education Note

The Board’s annual Jurisprudence Quiz is included as part of this Newsletter.  The questions in the quiz relate to the topics covered in this Newsletter as well as the May, August, and November 2003 News­letters.  If you need them, copies of the previous Newsletters can be found on the Board’s Web site at www.pharmacy.ohio.gov by clicking on “C.P.E. News and S.B.N.”

Please note that the deadline for submission of the completed quiz is March 31, 2004.  Any answer sheets postmarked after March 31 will not be accepted for grading.


Final CPE Reminder

This is a final reminder to those pharmacists whose license number begins with 03-1.  This is the year for you to report your continuing pharmacy education (CPE).  It will be due in the Pharmacy Board office no later than May 15, 2004.

Beginning this year, we are splitting the CPE reporting and the license renewal periods.  The CPE report forms should be arriving in your mail sometime early in March, while your renewal forms will not be arriving until mid summer.  If you have not received your CPE reporting form by the end of March, please notify the Board office so we can send you a replacement.  The CPE reporting forms will also be available on the Board’s Web site under “Forms,” which can be filled out online; then you can print, sign, and mail them to the Board office.

In addition, please be sure that you have the certificates in hand before you enter the number on the form.  Every year, we have a few pharmacists who put numbers down before they receive their cer­tificate from the continuing education provider.  Sometimes that certificate then fails to arrive because they did not pass the exam.  Falsifying the CPE Report Form is not something that the Board takes lightly.  As long as you have the originals in your possession when you complete the reporting form, you should have no problem with this reporting period.  If you fail to submit a CPE form in a timely manner, your renewal appli­cation will not be mailed to you until your CPE form is received and you have met the CPE requirement.


New, Revised Rules Filed

The Pharmacy Board filed several new and revised rules that became effective January 1, 2004. The full text of these rules, showing changes, can be found on the Board’s Web site. Click on “What’s New” and you will find the documents with the new rules.

Included in this filing are the rules for the Drug Repository Program. Because of the interest in this program, these rules are also contained in a separate document. Anyone who is interested in determining the requirements for participation in this program should carefully review these rules before starting. It should be noted that the drugs that may actually be used in this program will be limited. The majority of outpatient prescription drugs dispensed will not be eligible for use in the program since they are not in tamper-evident packaging.

By law, this program does not go into effect until April 7, 2004. Prior to that date, no out­patient prescription drugs may be returned for any reason. Our rules were filed early to allow inter­ested parties to begin the planning and implementation processes. If there are any questions about this program, we encourage you to call the Board office before you start.


Disciplinary Actions

Anyone having a question regarding the license status of a particular practitioner, nurse, phar­ma­cist, pharmacy intern, or dangerous drug distributor in Ohio should contact the appropriate licensing board.  The Web sites listed below may include disciplinary actions for their respective licensees.

State Dental Board--614/466-2580, www.dental.ohio.gov

State Medical Board--614/466-3934, www.med.ohio.gov

State Nursing Board--614/466-3947, www.nursing.ohio.gov

State Optometry Board--614/466-5115, www.optometry.ohio.gov

State Pharmacy Board--614/466-4143, www.pharmacy.ohio.gov

State Veterinary Medical Board--614/644-5281, www.ovmlb.ohio.gov

Drug Enforcement Administration--800/230-6844; www.deadiversion.usdoj.gov

State Pharmacy Board:

The disciplinary actions listed below include only those where the individual’s license to practice has been suspended, revoked, or restricted, and do not include any other actions taken by the Board.  All actions may be seen in the minutes, which are posted on the Board's Web site, then click on "Board Minutes."

Orders of the Board:

Douglas Edward Birkhimer, RPh; Columbus – License suspended indefinitely effective December 10, 2003, and may not be employed by or work in a facility licensed by the Board while suspended.

Michael M. Fraulini, RPh; Franklin Furnace – License reinstated effective October 22, 2003; May not serve as a preceptor or train pharmacy interns, may not serve as a responsible pharmacist, and may not destroy or witness the destruction of controlled substances for five years effective October 16, 2003.

Karen S. Frederick, RPh; Fremont – License reinstated effective December 22, 2003; May not serve as a preceptor or train pharmacy interns, may not serve as a responsible pharmacist, and may not destroy or witness the destruction of controlled substances for five years effective December 10, 2003.

Alan Patrick Horvath, RPh; Hilliard – License suspended indefinitely effective December 10, 2003, and may not be employed by or work in a facility licensed by the Board while suspended.

Steven Ray Liles, RPh; Cold Spring, KY – License suspended indefinitely effective December 10, 2003, and may not be employed by or work in a facility licensed by the Board while suspended.

Richard A. Petrilla, RPh; Canfield – License suspended effective September 10, 2003, minimum of two years, and may not be employed by or work in a facility licensed by the Board while suspended.

George L. Plataz, RPh; Willoughby – License reinstated effective November 17, 2003; May not serve as a preceptor or train pharmacy interns, may not serve as a responsible pharmacist, and may not destroy or wit­ness the destruction of controlled substances for five years effec­tive November 5, 2003.

John J. Sholtis, RPh; Steubenville – License suspended indefinitely effective December 10, 2003, and may not be employed by or work in a facility licensed by the Board while suspended.

Raymond Frederick Strahley, Jr, RPh; Hartville – License reinstated October 8, 2003, and during the first 12 months of practice may only work no more than 40 hours per week with a phar­ma­cist whose license is in good standing; May not serve as a preceptor or train pharmacy interns, may not serve as a responsible pharmacist, and may not destroy, assist in, or witness the de­struc­tion of controlled substances for five years effective September 10, 2003.

Settlement Agreements

Sam J. Postolski, RPh; Cincinnati – May not serve as a preceptor or train pharmacy interns, may not serve as a responsible pharmacist, and may not destroy or witness the destruction of con­trolled substances for 18 months effective January 5, 2004.

David L. Rieder, RPh; Chillicothe – May not serve as a preceptor or train pharmacy interns, may not serve as a responsible pharmacist, and may not destroy or witness the destruction of con­trolled substances for two years effective September 8, 2003.

Maynard D. Turner, RPh; Bloomingburg – License suspended indefinitely effective September 8, 2003, and may not be employed by or work in a facility licensed by the Board while suspended.

Summary Suspensions: [Sec. 3719.121 of the Revised Code]

Scott David Beach, RPh; Bluffton. Effective November 5, 2003.

John David Campbell, RPh; Nashport. Effective October 29, 2003.

Nancy Lee Dawson, RPh; Uniontown. Effective November 4, 2003.

Zachary Daniel Hennekes, RPh; Maineville. Effective December 24, 2003.

Tim Ivan Miller, RPh; West Lafayette. Effective December 24, 2003.

James Joseph Parsley, RPh; Wheelersburg. Effective December 24, 2003.

Pauline M. Reed, RPh; Whitehouse. Effective October 29, 2003.

Venubabu Talasila, RPh; Franklin. Effective December 9, 2003.

Elizabeth Marie Warner, RPh; Lakewood. Effective November 4, 2003.





National News Section


Applicability of the contents of articles in the National Pharmacy Compliance News to a particular state or juris­diction should not be assumed and can only be ascertained by examining the law of such state or jurisdiction.


Half of Certified Disease Managers Compensated for Services

According to a study performed by the National Institute for Standards in Pharmacists Cre­den­tial­ing, more than half of all pharmacists certified in disease state management (DSM) report com­pen­sa­tion for their services. Certified disease managers (CDMs) receive compensation for their services 57% of the time either personally or at their place of work. Results also indicated that 64% of CDMs cur­rently provide DSM to the patients they serve.

Nearly 70% of respondents in the nationwide survey practice in a community independent or chain set­ting. DSM services offered included diabetes (59%), dyslipidemia (20%), anticoagulation (13%), and asthma (8%). CDMs also provide services in smoking cessation, hypertension, congestive heart failure, osteo­porosis, immunization, depression, headache management, weight manage­ment/­nutrition, and hormone replacement therapy.

Other key findings from the survey include:


Thirty-four percent of CDMs spend between 1% to 10% of their time on patient care activities, while more than 66% of CDMs spend more than 10% of their time directly with the patient. 


More than half of the respondents spend less than 51% of their time on administrative activities related to the provision of these cognitive services. 


Nearly half of the respondents said that less than 10% of their businesses deal with DSM activi­ties. Twenty-two percent mentioned that more than half of their business comes from the DSM services they provide. 


While 80% of CDMs use a paper system to document clinical activities, the majority of respon­dents would be interested in an electronic documentation system for both clinical and billing activities. 


Sixty-four percent mentioned that private or state-sponsored DSM programs exist that utilize pharmacists as the health care provider. 


Lack of time, compensation, and employer support were the main reasons that 33% of respon­dents do not offer DSM to their patients. 

Currently, there are 964 pharmacists credentialed in diabetes, 343 credentialed in asthma, and 178 and 136 credentialed in dyslipidemia and anticoagulation, respectively.


NCC MERP Issues Guide to Help Non-hospital Settings Decrease Medication Errors

Five recommendations intended to prevent or reduce medication errors in non-healthcare or medical service-based settings have been released by The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP), according to the October 20, 2003 issue of Drug Topics.

Examples of these settings include schools, child and adult day care centers, assisted living facilities, group homes for the developmentally challenged, and correctional facilities. Because of the growing num­ber of unlicensed personnel who are administering medications in these settings, NCC MERP suggested that these institutions take the following five steps:


Develop written policies and procedures for personnel who administer medications. 


Provide training to personnel who are responsible for medication management. 


Ensure that controlled medications are stored properly to prevent theft and diversion. 


Encourage personnel to report medication errors to the appropriate state and national drug error-reporting programs. 


When a medication error occurs, evaluate possible causes in order to improve the facility’s system for drug management and to prevent future errors. 

For more information on NCC MERP’s recommendations, visit www.nccmerp.org.


Is an Antithyroid or Antimetabolite Needed? Preventing Confusion Between Propylthiouracil and Purinethol

This column was prepared by the Institute for Safe Medication Practices (ISMP). ISMP is an in­de­pend­ent non­profit agency that works closely with US Pharmacopeia (USP) and Food and Drug Admini­stration (FDA) in analyzing medication errors, near misses, and potentially hazardous conditions as reported by pharmacists and other practitioners. ISMP then makes appropriate contacts with com­panies and regulators, gathers expert opinion about prevention measures, then publishes its rec­om­men­da­tions. If you would like to report a problem confidentially to these organizations, go to the ISMP Web site (www.ismp.org) for links with USP, ISMP, and FDA. Or call 1-800/23-ERROR to report directly to the USP-ISMP Medication Errors Reporting Program. ISMP address: 1800 Byberry Rd, Huntingdon Valley, PA 19006. Phone: 215/947-7797. E-mail: ismpinfo@ismp.org.

A community pharmacist accidentally dispensed the antithyroid medication propylthiouracil 50 mg instead of PURINETHOL (mercaptopurine) 50 mg, an antimetabolite for a child with acute lymphoblastic leukemia. His parents noticed that the tablets looked different, but the pharmacist mistakenly believed that a generic product existed and reassured the parents that it was the correct drug. The child received the wrong drug for 6 months. No harm occurred, but he missed 6 months of chemotherapy. Modifications in the therapy and numerous thyroid blood levels were needed.

This is one of several reports in which propylthiouracil was dispensed instead of mercaptopurine. Con­versely, mercaptopurine has been dispensed and administered when propylthiouracil had been prescribed. Since propylthiouracil doses are often several hundred milligrams a day, mistakes that result in giving mercaptopurine at these high doses could lead to significant harm, including bone marrow suppression, hepatotoxicity, immunosuppression, and teratogenicity. In one reported case, the patient developed pancytopenia and hepatotoxicity.

The two products are often located next to each other, contributing to the risk of an error. Name similarity also is a problem. Although the drug names appear to be quite distinct, there are several common characters that may lead to confusion: both names start with “P” and end with “L”; 50 mg tablet strengths are common to both; and phonetically, the “your” sound in “purine” and “uracil” in­crease the risk of an error. Also, propylthiouracil is often abbreviated “PTU,” which can be confused with “Purinethol” or “6MP,” a dan­ger­ous abbreviation sometimes used for mercaptopurine.

On several occasions, GlaxoSmithKline, the manufacturer of Purinethol, has sent alerts to pharmacists about the potential for this type of error. Along with their most recent alert in June 2003, they distributed “shelf shouters” that pharmacists can place wherever Purinethol is stored to remind staff about confusion with propylthiouracil and to confirm the indication with the patient. You might also consider affixing aux­iliary labels to the drug containers or adding alerts to computers, especially if these drugs are not used frequently.

Never store these drugs in close proximity. Even if prescriptions have been properly entered into the computer, the incorrect product could be selected if the two medications are near each other. Pharmacies that use bar coding or match the drug container’s national drug code number against the one listed in the computer database (and printed along with the label) are less likely to select the wrong container.

Fully investigate patient-reported differences in tablet appearance. Some pharmacy computer systems can provide a picture of each tablet on the screen to help ensure accurate dispensing. Of course, patients should be counseled before either of these medications is dispensed in an outpatient setting; the coun­sel­ing session could quickly alert a pharmacist to a potential mix-up. Prescribers can help avoid errors, too, by listing brand and generic names on prescriptions for Purinethol. Drug names should not be abbreviated; in particular, PTU and 6MP should never be used. If abbreviations are used, a pharmacist should always verify the order with the prescriber before dispensing the product.


FDA Approves First Chewable Contraceptive

The United States Food and Drug Administration approved Ovcon 35, the first chewable birth control pill. Ovcon 35 is a spearmint-flavored oral contraceptive tablet that can be chewed and swallowed. It con­tains a progestin (norethindrone) and an estrogen (ethinyl estradiol) found in products that are already available.

The chewable birth control pill may be swallowed whole or chewed and swallowed; if chewed then swallowed, the woman should drink a full eight ounce glass of liquid immediately afterwards so that the full dose of medication reaches the stomach and no residue is left in the mouth. Ovcon 35 is only avail­able in a 28-day regimen and each package contains 21 round, white tablets, with norethindrone and ethinyl estradiol followed by seven reminder inactive tablets to complete a four-week cycle.

The risks of Ovcon 35 are similar to those of other oral contraceptives including an increased risk of blood clots, heart attack, and stroke, especially in smokers over the age of 35.


Next Paper-and-Pencil FPGEE Announced

NABP recently announced the newest dates for the paper-and-pencil Foreign Pharmacy Gradu­ate Equivalency Examination® (FPGEE®). The next two examinations will be held June 26, 2004, and Decem­ber 4, 2004. Locations are yet to be determined.

The December 6, 2003, administration of the FPGEE sat 2,050 candidates in Brooklyn, NY; Northlake (Chicago area), IL; and San Mateo (San Francisco), CA. Candidates should have received their scores 10-12 weeks after the test date.

For more information about the December 6 FPGEE administration or the next two examination dates, please go to NABP’s Web site located at www.nabp.net, or contact the Association’s Customer Service Department at 847/698-6227 or custserv@nabp.net.


Register Now for NABP's 100th Annual Meeting and Centennial Celebration

NABP’s 100th Annual Meeting and Centennial Celebration is fast approaching, so be sure to register now. The event will take place April 24-27, 2004, at The Fairmont Chicago in Chicago, IL.

Attendees of the meeting can earn continuing education credits and learn about new products and technologies in the Educational Presentation Area as well as find out about hot topics state boards are dealing with at the second annual Poster Session. This year at the Poster Session, NABP will also be hosting a bulletin board that details the history and accomplish­ments of the Asso­cia­tion.

For more information, or to register for NABP’s 100th Annual Meeting and Centennial Cele­bration, go to the Association Web site at www.nabp.net or contact the NABP Meetings Desk at 847/698-6227.