Hana Morrissey

Constituents of smoke from cigarettes made from diverted nicotine replacement therapy patches

INTRODUCTION AND AIMS Anecdotes of nicotine replacement therapy patch misuse associated with the introduction of smoke-free prisons have been reported by media internationally, including Canada in 2006, New Zealand in 2011 and Australia in 2014. This study identifies chemical compounds released through diverted nicotine replacement therapy patches when they are smoked. DESIGN AND METHODS Two samples were produced: (i) shredded 21 mg nicotine replacement therapy patches rolled with tea leaves into a cigarette; and (ii) patches boiled in water and tea leaves, and then dried tea leaves rolled into a cigarette. The smoke was tested for nicotine, caffeine and toxins. High-performance liquid chromatography, mass spectrometry and spectrophotometry were used to detect the presence and quantity of nicotine and caffeine. A specialised laboratory was contracted to test the presence of toxins. RESULTS Nicotine was liberated when the two samples were burnt but not if the nicotine replacement therapy patches were boiled in water alone. High concentrations of formaldehyde, acetaldehyde, acrolein, toluene, xylene and heavy metals were also released. DISCUSSION AND CONCLUSION Nicotine is released when diverted nicotine replacement therapy patches are smoked, as are caffeine and harmful toxins. These toxins have the potential to cause short- and long-term health damage.

An Initiative to Ensure Profession Preparedness

Bushell MJ1*, Hana Morrissey3 and Patrick Ball2 1Pharmacy Discipline, School of Psychological and Clinical Sciences, Faculty of Engineering, Health, Science and Environment, Charles Darwin University, Casuarina NT 0810, Australia 2Pharmacy Discipline, School of Psychological and Clinical Sciences, Charles Darwin University Casuarina Campus, Australia 3Faculty of Engineering, Health, Science and Environment, Charles Darwin University Casuarina Campus, Australia

Sri Lankan Perspectives on Pharmacist Administered Vaccinations

Background: Globally, the administration of vaccines by pharmacists is gaining momentum and incorporation of vaccination and injection skills in pharmacy school curricula is becoming more common. Objectives: This paper reports on one of four focus groups conducted to validate an Australian developed undergraduate vaccination training program (VTP) and its wider application beyond the Australian health care environment. Methods: A focus group discussion was conducted with six Sri Lankan medical and pharmacist experts following the development of a vaccination training program. Results: Participants voiced that prior to incorporation of the VTP into undergraduate Sri Lankan curricula, approval should be sought from the Ministry of Health and established vaccinators. The issue of certificates of competency was deemed inappropriate to be issued to Sri Lankan students. Additionally the assessment of competency was seen to be essential on a yearly basis throughout the curricula. Concern was expressed concerning the management of vaccine associated anaphylaxis in the context of minimal pre-hospital care. Participants voiced that vaccination training should be piloted prior to formal incorporation into Sri Lankan undergraduate pharmacy curricula Conclusion: While there is wide interest in the introduction of clinical skills into pharmacy curricula, the results of this study raise questions about the inclusion of injection and vaccination training in Sri Lankan undergraduate curricula.

Barriers to early detection of cognitive impairment in the elderly despite the availability of simple cognitive screening tools and the pharmacist’s role in early detection and referral

The aim of this review is to identify a suitable cognitive screening tool that can be used by the pharmacist during home medication review in addition to calculating the medications’ total anticholinergic burden (ACB).

Stability and Sterility Data in Pre-Filled Syringes for Zuclopenthixol Acetate and Haloperidol Used in Emergency Tranquilisation

Background: Needle stick injuries are a known risk in the acute hospital setting especially where the patient is agitated. The emotional burden on the staff experiencing this occupational injury is well reported, however there is insufficient data to support storing pre-filled syringes, out of the manufacturer’s pack for longer than for immediate administration. Aim: The aim was to investigate the stability and sterility of zuclopenthixol acetate and haloperidol in pre-filled syringes to allow their use as an alternative to drawing the dose from an ampoule or vial prior to administration. Method: Two of the commonly used products in rapid tranquilisation were aseptically drawn in suitable syringes and tested for stability and sterility to establish shelf-life. Ten invited medical and nursing staff involved in rapid tranquilisation were invited to a focus group for feedback on the product practicality of use, cost and logistics of stock management. Results: The stability and sterility tests show that zuclopenthixol acetate and haloperidol retained stability and sterility when stored under 25°C in a 3 mL disposable plastic syringes, for a period of 60 days with cost of AU

In vitro analysis of the effect of in-line 1.2 micron filters on two formulations of propofol (2,6-diisopropyl phenol).

67 and AU

Viability and sustainability of pharmacist input in chronic disease management in rural Australia

30 per syringe respectively. Conclusion: The prefilled syringes provide ease and speed of administration, potential reduction in needle-stickinjuries and proved to maintain sterility. This study demonstrated that zuclopenthixol acetate 150 mg/3mL and haloperidol 15mg/3mL retained stability and remained sterile when stored under 2-8°C in plastic syringes for a period of 60 days. However the proposal was not adopted as dose flexibility was considered a greater priority than the safety gains.

Pharmacy Studentsʼ Preparedness to Communicate With Mental Health Disorders Patients

Recent evidence has shown improved outcomes in pediatric intensive care units with the intensive use of intravenous in-line filtration. This has caused resurgence in interest in filter use but has raised questions in relation to emulsion-based formulations such as propofol. Our objective was to test two propofol products, Diprivan® and Fresofol®, with the Pall Lipipor® TNA and Lipipor NLF intravenous in-line filters and to assay the content before and after filtration under typical infusion conditions. The propofol emulsions were delivered from a 50 mL syringe through an extension set and into either a Lipipor TNA (50 mL/h–1) or Lipipor NLF (20 mL/h–1) filter. Samples were taken at regular intervals and assayed using a high-performance liquid chromatography method before and after filtration. No evidence was found of a significant concentration change during passage of either product through either model of filter. Propofol from two products was found to pass through two different types of Pall 1.2 μm intravenous in-line filters. There was no significant change in concentration before and after filtration under typical conditions of administration. In conclusion, administration of these products through these models of in-line filter would be safe and effective.

Pharmaceuticals in the tropics: A quantitative study measuring changes in quantity of the active ingredient and microbiological growth

Management of chronic disease patients is a complex continuum, led by doctors, but delivered by a range of health professionals at different levels of care, including primary care. Success is dependent upon adherence to the holistic therapy and on the accessibility and affordability of services.

Do Mental Health First Aid™ courses enhance knowledge?

Abstract The aim of this project was to explore whether fourth-year pharmacy students in England are prepared to communicate with mental health patients. Mental health problems are rising in the United Kingdom, affecting around one in four people. A questionnaire-based study measured the knowledge about and attitude toward mental health problems. Participants were fourth-year pharmacy students from two west midlands universities. More males than females correctly answered the “attitude towards mental health” questions. However, overall, only 45.5% of students answered the “attitude towards mental health problems” questions correctly. Males demonstrated a better level of knowledge than females, with 33% overall answering 6 or more questions of the 13 knowledge questions correctly. Sixty-five percent of participants scored under 50%. The highest total score was 81%, and the lowest was 19%, three people did not answer any questions. In conclusion, a gap in knowledge was identified within the fourth-year pharmacy student cohort, and more intervention will be required to improve knowledge and attitudes such as the Mental Health First Aid courses.