July/August 2020 Newsletter
In This Issue:
  • President's Message
  • Board Update
  • MSHP Annual Financial Report 
  • Public Policy Update
  • Annual Pharmacy School Updates
  • Pharmacist Continuing Education Articles
  • Use of Electronic Cigarettes: Risks, Benefits, and Recommendations
  • Got Calcium? Pharmacologic Treatment Options for Hypercalcemia
  • Featured Clinical Topic: Cardiology & Anticoagulation
  • Less May Be More: Appropriateness of Triple Antithrombotic Therapy in Patients with Atrial Fibrillation and Acute Coronary Syndromes
  • The Heart of the Matter: Evaluating Cardiovascular Benefit with Antihyperglycemic Medications
  • Direct Oral Anticoagulant Use in Patients with Cancer-Associated Thrombosis
  • Bempedoic Acid: A novel lipid lowering agent
  • SSHP Spring Updates
  • Affiliate Chapter News and Events
  • Upcoming Newsletter Info
  • NOTE: Sept/Oct & Nov/Dec are FULL
President's Message
By Davina Dell-Steinbeck, PharmD, BCPS; SSM Health St. Mary’s Hospital
“Don't make resolutions without an action plan. The secret to success is right in your hands.” - J. Allen Shaw 

“Volunteers do not necessarily have the time; they just have the heart.” - Elizabeth Andrew  

“Many hands make light work.” - Chinese Proverb

“Only by giving are you able to receive more than you already have.” - Jim Rohn 

Since I am an RPD and my new residents start in July, I always view July as a time to review the past year. I think about both personal and professional goals and if I’m on track for achieving them. If I’m not, I try to come up with a plan so that I will succeed. I recently completed this exercise for myself, for my residency program, and for MSHP.

Interested in joining a committee? Let us know here!
Board Update
By Davina Dell-Steinbeck, PharmD, BCPS-MSHP President; SSM Health St. Mary's, St. Louis 

  • Virtual Spring Meeting was successful and profitable
  • Strategic Planning meeting that usually occurs in June was moved to the Fall

  • Budget approval was moved to July
  • Reviewed updated Website/Social Media Committee policy
  • Sent out nominations for Secretary-elect and Technician liaison
  • Developed a process for giving MSHPs support when a quick turnaround is required. It was decided that the presidential group will make these decisions on behalf of the membership. A policy will be written describing this.
  • Earlier this year we sent out a vote to the membership on a change in the bylaws and the Tech Check Tech guidance document. 
MSHP Annual Financial Report 
By Elaine Ogden, PharmD, BCPS, BC-ADM

Each year, the MSHP Treasurer has the responsibility to provide a financial report to its membership. The fiscal year is July 1 through June 30th which coincides with the policy development process and timetable. The report below describes MSHP past and project financial performance ...

Public Policy Update
Regulation in Uncertain Times

By Nathan Hanson, PharmD, MS, BCPS, Health Trust Supply Chain
Every time we turn on the TV or Twitter feed, we face a barrage of facts and opinions about rules. From masks to sports to school policy to social justice, it is impossible to ignore the fact that rules and rule-makers play a huge role in our everyday lives. It is also an interesting case study in the interplay among the rules at the federal, state, and local level, as well as how those rules play out in the real world of businesses and organizations and the family. When done well, rules level the playing field and keep us safe. While there are certainly huge differences in opinions about the definition of ‘good rules,’ everyone can agree that more input from more voices is the best way to create them.

Annual Pharmacy School Updates
UMKC School of Pharmacy Update

By: By Russell Melchert, PhD; Dean, UMKC School of Pharmacy

“Mulligan” is defined by the New American Oxford Dictionary as “an extra golf stroke allowed after a poor shot, not counted on the scorecard”. In my not so professional golf experience, I have requested and utilized numerous mulligans, and sadly, even those didn’t help my score that much. Had it not been for some really great accomplishments from UMKC students, staff, and faculty this past academic year (okay, and maybe the Chiefs winning the Superbowl as well), I would have to call on a mulligan for 2020. Despite the difficult year, the school continued to thrive and excel. 

St. Louis College of Pharmacy Update

By: Brenda Gleason, Interim Dean of Pharmacy 

As we close out the 2019-20 academic year at St. Louis College of Pharmacy, we are reflecting on a year filled with extraordinary accomplishments and challenges. Over the past 12 months, we have seen our institution recognized nationally as the top college in the U.S. for return on investment at 15 and 20 years after enrollment, and we’ve watched as extensive growth in our research initiatives has continued, with the College earning honors as the top-ranked private college of pharmacy in the nation for National Institutes of Health grant funding. Amid this incredible recognition for the College, we, like other colleges and universities nationwide, also have been navigating unique challenges stemming from the Coronavirus 2019 (COVID-19) pandemic.

Use of Electronic Cigarettes: Risks, Benefits, and Recommendations 

By: Kacee Verhovec, PharmD; PGY1 Community-Based Pharmacy Resident

Mentor: Michelle Jeon, Pharm.D., BCACP, Walgreens/St. Louis College of Pharmacy
In August 2019, concerns about electronic cigarette use began to grow after the first death associated with the inhaled product was reported. Within several months, the death toll reached 68 in February 2020 with nearly 3,000 additional cases leading to hospitalization. Unfortunately, safety concerns continued to grow as electronic cigarettes gained popularity in the younger population. How did we get to this point? 

Program Number: 2020-06-04 
Approval Dates: 7/1/2020 – 1/1/2021 
Approved Contact Hours: 1 hour 
Got Calcium? Pharmacologic Treatment Options for Hypercalcemia 

By: Brooke Lucas, PharmD and Kelsey Sachtleben, PharmD; PGY1 Pharmacy Residents

Mentor: Emily Buchanan, Pharm.D., BCPS, SSM Health St. Clare Hospital
Calcium is one of the most abundant cations found in the human body and plays an important role in myocardial function, enzyme activity, neural transmission, coagulation, and other cellular functions. Most calcium is found in the bones with the remainder of calcium found in cells and extracellular fluid. Hypercalcemia affects approximately one to two percent of the general population, with most of these cases (90%) due to primary hyperparathyroidism and hypercalcemia of malignancy. Patients can often tolerate chronic hypercalcemia, but acute hypercalcemia can lead to more severe symptoms and up to a 50% mortality rate for patients with untreated hypercalcemia of malignancy.

Program Number: 2020-06-02 
Approval Dates: 7/1/2020 – 1/1/2021 
Approved Contact Hours: 1 hour 
Featured Clinical Topic:
Cardiology & Anticoagulation
Less May Be More: Appropriateness of Triple Antithrombotic Therapy in Patients with Atrial Fibrillation and Acute Coronary Syndromes

By: Kyle Stupca, PharmD; Mercy Hospital - Springfield
The incidence of atrial fibrillation (AF) in patients with acute coronary syndromes (ACS) ranges from 10% to 20% and increases with patient age and severity of myocardial infarction (MI). Subsequently, AF is associated with increased in-hospital mortality, 30-day mortality, and 1-year mortality. Stroke rates are higher in patients with MI and AF than those without AF with the incidence being 3.1% in patients with AF compared to 1.3% in patients without AF.

The Heart of the Matter: Evaluating Cardiovascular Benefit with Antihyperglycemic Medications

By: Meredith Vigneaux, PharmD; Mercy Hospital Springfield
The number one cause of death for patients with diabetes is due to cardiovascular (CV) disease, therefore lowering hemoglobin A1c with a medication that does not increase CV disease risk has become a central focus of diabetes treatment. Metformin was the first glucose lowering drug to demonstrate a positive effect on CV risk in the United Kingdom Prospective Diabetes Study (UKPDS), which ended in 1997.

Direct Oral Anticoagulant Use in Patients with Cancer-Associated Thrombosis

By: Ashley Jose, PharmD Candidate Class of 2021; St. Louis College of Pharmacy

Mentor: Emily Walsh, PharmD
Venous thromboembolism (VTE) is the second most common cause of mortality in patients with cancer and the most frequent complication of malignancy. The estimated annual incidence of VTE among the general population is 1 to 2 per 1,000 people. In patients with cancer-associated thrombosis (CAT), the estimated risk of VTE is four to six times higher, and overall survival rates are much lower with significantly worse prognosis. This increased risk of VTE is often multifactorial and can be caused by numerous patient and cancer-related factors, such as immobility, site and severity of cancer, stage and histology of the tumor, and treatment.

Bempedoic Acid: A novel lipid lowering agent

By: Jack Pluenneke, PharmD Candidate 2021 and Andrew Smith, Pharm.D., FCCP, BCCP, BCPS; UMKC School of Pharmacy
There has been a large amount of observational evidence supporting low-density lipoprotein cholesterol (LDL-C) as a causal risk factor for the development of atherosclerotic cardiovascular disease (ASCVD). With the emergence of genetic and clinical trials showing linear relationships between exposure to cholesterol, in particular LDL-C, and ASCVD risks, reducing LDL-C levels has become a standard in the prevention of cardiovascular disease. Lifestyle modification continues to be one of the most important and effective interventions in the management of high LDL-C levels.

Student Society of Health-System Pharmacy Spring Semester Updates 
St. Louis College of Pharmacy

By: Lauren Busch, STLCOP SSHP President and Maram Hamdan, STLCOP SSHP President-Elect; PharmD Candidates 2022

The St. Louis College of Pharmacy SSHP had a successful 2019-2020 school year despite the challenges presented by COVID-19 in the spring semester. The STLCOP SSHP held several residency preparation events including: the Introduction to Residency and CV 101 seminars led by faculty member Dr. Jack Burke; the Resident Roundtable with residents from all over the St. Louis area; and the Residency-Focused Mentorship Program events which continued to be expanded. The Residency-Focused Mentorship Program, which is a mentorship program between pre-professional students and students early in the pharmacy program (P1’s) and students later in the program (P2’s and P3’s), received the SSHP Outstanding Professional Development Project Award and was ...

University of Missouri – Kansas City School of Pharmacy

By: Brianna Chambers, PharmD Candidate 2022; UMKC SSHP President - Columbia and Samuel Halleck, PharmD Candidate 2022; UMKC SSHP President – Kansas City

UMKC’s SSHP chapter had a challenging but strong spring semester. In February, KSHP and KU School of Pharmacy invited us to join their Pharmacy Forecast Workshop. Students learned about emerging healthcare trends and future opportunities of pharmacy practice. Groups discussed and came up with possible solutions to current practice problems involving electronic health records, Big Data, and payment reform. We had 80 members of the UMKC SSHP chapter attend this wonderful ...

Affiliate Chapter News & Events
Greater Kansas City Society of Health-System Pharmacists (GKCSHP) 

President: Ashley Duty, PharmD, MS (ashleymduty@gmail.com)

Mid-Missouri Society of Health-System Pharmacists (MMSHP) 

Like us on Facebook! www.facebook.com/mymmshp/  

President:  Sandy McGraw, PharmD, BCPS (mcgrawa@health.missouri.edu

Saint Louis Society of Health-System Pharmacists (STLSHP) 

President: Gabrielle Gibson, PharmD, BCPS, BCCCP (gabrielle.gibson@bjc.org

Southeast Missouri Society of Health-System Pharmacists (SEMSHP) 

President: Janice Wesbecher, PharmD, BCPS (jbueter@sehealth.org
Upcoming Newsletter Info
Upcoming Featured Clinical Topics 

Sept/Oct 2020 – Pediatrics FULL

Nov/Dec 2020 – ID/Vaccines FULL

Submit to: Sarah Cook
Newsletter Submission Deadlines:

Sept/Oct 2020: September 14th

Nov/Dec 2020: November 9th
Newsletter Submission Guidelines

  • Pharmacists, pharmacy technicians, and pharmacy students in Missouri are eligible to submit content for publication in the MSHP Newsletter. Student submissions need to include pharmacist oversight.

  • Submit content to the current Newsletter Committee Chair on or before the established deadlines.

  • CE and Featured Clinical Topics must be approved by the Newsletter Committee Chair in advance of article submission, to prevent duplicates. Duplicate articles submitted without advanced approval may not be published.

  • Recommended length of submissions for committee, affiliate, college/schools of pharmacy, and student chapter reports is half to one page in length.

  • Recommended length of submissions for featured clinical topics is 1 to 2 pages, without references.

  • Recommended length of CE articles is individualized, based on the amount of CE provided.

  • Recommended length of submission for other categories is 1 to 2 pages.
MSHP Board of Directors & Committee Chairs
2020-2021 Board Members

President:  Davina Dell-Steinbeck

President-Elect: Christina Stafford

Immediate Past President: Alex Oschman

Secretary: Barb Kasper

Treasurer: Elaine Ogden
2020-2021 Committee Chairs

Vendor Relations Board Liaison - Evanna Shopoff

Membership Committee - Kristen Petersen

Public Policy Committee - Nathan Hanson

Newsletter Committee - Sarah Cook

Education and Programming - Rebecca Nolen

Website & Social Media - Bethany Baker
Questions & Comments
If you have any questions, comments, or wish to submit an article to for MSHP Newsletter, please contact the Newsletter Committee Chair (Sarah Cook) or another Newsletter Committee member.

2020-2020 MSHP Newsletter Committee Members
Sarah Cook, PharmD, BCPS (Chair)
Laura Challen, PharmD, MBA, BCPS, BCACP (Vice-Chair)
Yvonne Burnett, PharmD, BCIDP
Gabrielle Gibson, PharmD, BCPS, BCCCP
Rebecca Nolen, PharmD, BCPS, BCIDP, AAHIVP
Hannah Pope, PharmD, BCPS
Emily Shor, PharmD