September/October 2019 Newsletter
In this issue:

  • President's Message from Alex Oschman
  • Board Update
  • Research & Education Foundation Update
  • Public Policy Update
  • Pharmacist Continuing Education Opportunities
  • An Introduction to Chimeric Antigen Receptor T-Cell (CAR-T) Thereapy
  • Multi-Drug Resistant Gram-Negative Bacterial Infections and Novel Antibiotic Agents that Treat Them
  • Featured Clinical Topic – Oncology
  • Chemotherapy-Induced Nausea and Vomiting: A Review on Antiemetics Used for Treatment and Prevention
  • Role of Letermovir for CMV Prophylaxis in Hematopoietic Stem Cell Transplantation
  • Expanding Treatment Options for AML: A Focus on the IDH Inhibitors
  • Use of Direct Oral Anticoagulants in Cancer Patients
  • Parity Struggle Between Chemotherapy Dosage Forms
  • Affiliate Chapter News and Events
  • Upcoming Newsletter Info
President's Message
from Alex Oschman
Don’t give up! I believe in you all! A person’s a person, no matter how small – Dr. Seuss

Fall is here! While I love summer, fall is probably my favorite season for a variety of reasons. Whether your favorite fall activity is visiting apple orchards, consuming all things pumpkin, or watching football, enjoy these few months before the cold weather rolls in.

Board Update
Davina Dell-Steinbeck, PharmD, BCPS
MSHP President Elect/SSM Health St. Mary's Hospital

July Updates
  • New board transitioned! All new officers and committee chairs are now in their new roles.
  • Discussed restructuring the leadership of the Education and Programming Committee to be a three-year cycle.
  • Year 1: Co-chair for Education
  • Year 2: Co-chair for Spring Meeting Planning
  • Year 3: Chair of Education and Programming Committee (with an additional position on MSHP Research and Education Foundation)

August Updates
  • Finalized and approved strategic plan
  • Reviewed membership survey results
Research & Education
Foundation Update
We Want to Learn from You!!
Jackie A. Harris, Pharm.D, BCPS, Executive Director, MSHP Research & Education Foundation

What better way to learn than by learning from our colleagues! We’d love to share your recent publications with MSHP. Please submit your recent citation so that we can highlight your hard work and dedication to advancing pharmacy practice in Missouri.

Don’t forget that the 2020 Best Practice Theme is Innovative Stewardship Roles. Start thinking about what your hospital has been doing surrounding stewardship. Have you had success with your Antibiotic Stewardship program? Or have you started working on Opioid stewardship to combat the opioid epidemic? If you answered yes to any of the questions, you should start measuring your success and watch for the Best Practice Award submission deadline this winter. 

New This Year!!
The Tonnies Preceptor Award will be replacing the Preceptor of the Year Award in 2020. The MSHP R&E Foundation is pleased to honor a health system pharmacist for outstanding service to the profession as a preceptor to pharmacy students and/or residents. The Tonnies Preceptor Award will be presented each year to a deserving candidate who has been nominated in recognition of sustained contributions in the following areas:
  • Outstanding accomplishment in precepting learners in health system pharmacy;
  • Sustained contribution to mentoring students/residents in the research process;
  • Demonstrated activity with pharmacy students from St. Louis College of Pharmacy or the UMKC School of Pharmacy;
  • Contributions to the profession through service to ASHP, MSHP, and/or local affiliates.

Know anyone deserving? The eligibility and criteria will be posted on the MSHP R&E website shortly.  
Public Policy Update
Health-System Policy Recommendations for Medical Marijuana
Authors: Borden Edgar, UMKC PharmD Candidate 2019; and Sarah Cox, PharmD, MS

Medicinal marijuana is a growing topic being discussed in Missouri. Recently, Missouri passed Amendment 2, which enacted a new section to be known as Section 1 of Article XVI of the Missouri Constitution 1 . This change allowed the use of medical marijuana for certain medical conditions. However, marijuana is classified as a schedule I controlled substance by the Drug Enforcement Agency (DEA) 2 . This may pose a challenge to health-systems when caring for patients licensed and legally using medical marijuana under state law. According to the Missouri Department of Health and Senior Services (DHSS), patients could begin applying to receive a medical marijuana card on the 28 th of June. For an additional $100 fee, a patient may grow up to six flowering plants 1

Pharmacist Continuing Education
An Introduction to Chimeric Antigen Receptor T-Cell (CAR-T) Therapy

Author: Christopher Clayton, PharmD
Preceptor: Jacob Kettle, PharmD, BCOP

Program Number:  2019-07-03
Approval Dates:  October 1, 2019 – April 1, 2020
Approved Contact Hours: One (1) CE(s) per LIVE session

Multi-Drug Resistant Gram-Negative Bacterial Infections and Novel Antibiotic Agents that Treat Them

Author(s): Justice Oehlert, PharmD Candidate 2020 and Kathryn Lincoln, PharmD, BCPS, BCIDP, Clinical Pharmacist – Infectious Diseases, Olathe Medical Center

Program Number:  2019-08-06
Approval Dates:  October 1, 2019 – April 1, 2020
Approved Contact Hours: One (1) CE(s) per LIVE session

Featured Clinical Topic:
Chemotherapy-Induced Nausea and Vomiting: A review on Antiemetics Used for Treatment and Prevention
Authors: Betsy Abraham, PharmD: PGY-1 Pharmacy Resident, NorthShore University Health-System
Katie Lentz, PharmD, BCOP: Oncology Clinical Pharmacy Specialist, Barnes-Jewish Hospital
Nausea and vomiting are common in patients who are on chemotherapy. A recent analysis of 991 patients receiving chemotherapy showed an incidence of anticipatory nausea of 8 to 14%, with rates increasing with each subsequent cycle. 1  Patients beginning a cancer treatment consistently list chemotherapy-induced nausea and vomiting (CINV) as one of their greatest fears. 2  

Role of Letermovir for CMV Prophylaxis in Hematopoietic
Stem Cell Transplantation
Authors: Avatar Patel, PharmD Candidate 2020;
Marissa Olson, PharmD, BCOP and Kristan Augustin, PharmD, BCOP
Cytomegalovirus (CMV) is the largest β-herpesvirus transmitted by direct contact with infectious body fluids and is prevalent in over half of adults by the age of 40 years. 1 CMV infection and disease are often characterized together, although they are not synonymous. CMV infection refers to the detection of viral antigens in tested bodily fluid or tissue, while CMV disease refers to symptomatic end-organ disease. 2 While most individuals do not have signs or symptoms associated with CMV infection, primary infection leads to life-long latency. 

Expanding Treatment Options for AML: A Focus on the IDH Inhibitors
Authors: Nicholas Pauley, PharmD Candidate 2020 and
Mallory Crain, PharmD
Acute myeloid leukemia (AML) is the most common form of acute leukemia in adults. 1 The average age at diagnosis is 69 years with a 5-year survival rate of 28.3%. 2 A key determinant for increased survival is the patient’s ability to undergo intense induction chemotherapeutic regimens. However, intensive therapies are not always an option since some patients are unable to tolerate these treatments due to age and comorbidities. Fortunately, targeted therapies have expanded treatment options for these patients.

Use of Direct Oral Anticoagulants in Cancer Patients
Authors: Marissa Chow, Pharm.D. Candidate Class of 2021 and
Emily Shor, Pharm. D.
Patients with malignancies have a 20% to 30% increased risk for venous thromboembolism (VTE), such as deep vein thrombosis (DVT) and pulmonary embolism (PE), due to their hypercoagulable state. 1-3  Additionally, a VTE at the time of or within one year of cancer diagnosis is correlated with more advanced stages of cancer and increased risk of death. 4 The 2019 NCCN and 2016 CHEST guidelines recommend that patients with a cancer associated VTE be anticoagulated for at least three months or indefinitely while cancer is active, patient is undergoing treatment, or risk factors remain present. 2-3,5  However, the NCCN guidelines do not provide recommendations regarding routine VTE prophylaxis in ambulatory cancer patients unless they have certain risk factors, such as certain cancer types and/or chemotherapy agents.   2  Managing cancer-associated thrombosis (CAT) must balance both a patient’s increased risk of recurrent VTE patients alongside risks of bleeding. 

Parity Struggle Between Chemotherapy Dosage Forms
Authors: Shu-wen Tran, B.S., UMKC PharmD Candidate 2020 and
Diana Tamer, B.S., Pharm.D., BCOP
How is it possible that patients with certain metastatic cancers are still treated with traditional chemotherapy when targeted precision medicine is available for them as first line agents? While sequencing the whole genome led to having technologies today to sequence each patient’s tumor DNA, and finding targeted therapies for tumorigenesis driving mutations; these therapies are costly and not affordable to most patients—even those with insurance coverage. Is there any way to drive down the cost of oncolytic agents? Let’s explore some avenues. 

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

First congratulations to our Annual Awards Recipients:
  • Pharmacist of the Year: Ashley Holmes, Saint Luke’s Hospital (previously worked at Olathe Health)
  • Student of the Year: Carly Kempf, UMKC
  • Technician of the Year: Nikki Hernandez, Saint Luke’s Hospital 

Upcoming Events:
October 3rd, 2019: Rethinking the Approach to the Treatment of Hyperkalemia
Location: Fogo de Chao

October 17th, 2019 : ANAVIP Antivenin for the Management of Patients with Rattlesnake Envenomation
Location: Brio

November 7th, 2019: Location and Topic TBD

November 21st, 2019: Rivaroxaban update
Location: Lidia's Kansas City
GKCSHP is on Instagram! Follow us @gkcshp!

President: Bradley Bingham, PharmD
Mid-Missouri Society of Health-System Pharmacists (MMSHP)

Upcoming MMSHP Events:
We have dinner presentations lined up for 10/3/19, and 10/24/19, but locations and times are to be determined.

President: Emily Wiederanders , PharmD
Saint Louis Society of Health-System Pharmacists (STLSHP)

Upcoming Event:
The St. Louis Society of Health-System Pharmacists (STLSHP) will be co-hosting a Networking Happy Hour event with the Gateway College of Clinical Pharmacy (GCCP) this fall on November 8 th , immediately following the Continuing Education (CE) Resident Seminar presentations at St. Louis College of Pharmacy. Details about the location of the event will be coming soon, but mark your calendars for this first ever collaboration of our two St. Louis based organizations!

President: Erin Hennessey , PharmD, BCPS
Southeast Missouri Society of Health-System Pharmacists (SEMSHP)

To join SEMSHP:

President:   Julie Haase , PharmD, BCPS, BCCCP
Upcoming Newsletter Info
November/December 2019 Newsletter

Featured Clinical Topic:  
Infectious Disease/Vaccines

Submit to: Laura Challen
2020 Featured Clinical Topics
Jan/Feb – Endocrinology
Mar/Apr Psych/Neuro/Pain 
May/June – Critical Care/Pulm/Emergency Med
July/Aug – Cardiology/Anticoagulation
Sept/Oct – Pediatrics
Nov/Dec – ID/Vaccines 
Newsletter Submission Deadlines:
Nov/Dec 2019: November 11th
Jan/Feb 2020: January 13th
March/April 2020: March 9th
May/June 2020: May 11th
July/August 2020: July 13th
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.
Is there a Pharmacy Best Practice happening at your institution? Would you like to share your successes with MSHP Membership? We'd love to highlight your institution in a future MSHP Newsletter!

Please contact the MSHP Newsletter Chair, Laura Challen
Interested in becoming a MSHP member or need to renew? It's easy! Click the above button or visit the MSHP website:

Membership Dues:
Pharmacist: $110
Joint Pharmacist: (Married Couple) $155
Technician: $35
Associate Member: $110
Recent Graduate (within 24 months): $45
Student: $25
Retired Pharmacist: $35
MSHP Board of Directors
2019-2020 Board of Directors
President: Alex Oschman
President-Elect: Davina Dell-Steinbeck
Immediate Past President: Tony Huke
Secretary: Barb Kasper
Treasurer: Christina Stafford
MSHP Committee Chairs
2019-2020 Committee Chairs
Vendor Relations Board Liaison -  Evanna Shopoff
Membership Committee -  Erin Hennessey
Communications Committee -  Barb Kasper
Public Policy Committee -  Sarah Cox
Newsletter Committee -  Laura Challen
Education and Programming -  Elizabeth Englin
Website Committee -  Lori Rio
If you have any questions, comments, or wish to submit an article to for MSHP Newsletter, please contact the Newsletter Committee Chair:
 Laura Challen or another Newsletter Committee member.

2019-2020 MSHP Newsletter Committee Members
Laura Challen, PharmD, MBA, BCPS, BCACP (Chair)
Sarah Cook, PharmD, BCPS (Vice-Chair)
Rebecca Nolen , PharmD, BCPS, AAHIVP
Hannah Pope, PharmD, BCPS
Emily Shor, PharmD
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