Editorial: False Economy? Think before you act!

This topic may be of benefit for pharmacies that are considering changing the lighting technology in their facilities.

A project by a large university involves retrofitting six parking structures with new light-emitting diode (LED) fixtures. They expect to save up to $127,000 annually in energy and maintenance costs. The project cost is about $1.5 million.

I guess a couple of questions we should consider before adopting new lighting technologies are:

1. When should we convert to more efficient and safer technologies for lighting?
2. What is the return on our investment?

Tungsten lighting technology has been around a long time and has served us well, despite the limited lifetime of the bulbs and the "yellowish" color of the lighting. They are quite inexpensive, and our society is based on this type of lighting.

Fluorescent tube lighting has also been around a long time and serves us with "whiter" lighting, easy to replace bulbs, and has been quite successful and economic.

Halogen bulbs that replace tungsten bulbs are "whiter" but are quite expensive and still have limited service.

Now, "enter LED technology!" These new small bulbs have a very long lifetime, from 50,000 to 100,000 hours for some of them. However, they are quite expensive and do not have the lumen output as the other technology unless many of them are put together in a single "bulb."

Regarding the university project above, it will take 11.8 years to pay for itself ($1,500,000/$127,000 per year savings) and by then, the lights will need to be replaced. This also does not necessarily include the effort and costs of raising the funds to obtain the money to do the project. Another consideration is the lower level of lumens generally put out by these LEDs and the potential impact on the safety of students and faculty.

There is no question that LED technology is great, as the LED lights last so much longer than metal halide or tungsten filament bulbs. However, there may be a more reasonable alternative to phase into a new system. For example, the new LED bulbs are now available using the same fixtures at home that we currently have with the screw-on base. Possibly by waiting a short time, the LED bulbs will be available for the fixtures for the parking structure and for commercial facilities. This will prevent having to "retrofit" existing facilities and the associated costs involved.

http://campustechnology.com/articles/2009/08/18/arizona-state-expects-127k-annual-savings-from-lighting-switch.aspx?sc_lang=en


Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief

The International Journal of Pharmaceutical Compounding's September/October 2009 (V13-I5) issue is on its way to our subscribers. This issue is on the topic of Veterinary Compounding, and we have put together an extended version—from our normal 88 pages to 96 pages. Not only have we included some excellent veterinary articles, but there is an article about the imbalance of interests between law enforcement by the DEA and patients requiring access to pain medicine, another interesting read about the history of aspirin, and other informative articles. We're quite proud of this issue and hope you enjoy reading it as much as we enjoyed putting it together. If you are interested in acquiring additional copies of this veterinary issue, please contact Deb at dmehlhaff@ijpc.com or at (800) 757-4572 ext. 1.

Gardasil's Safety in Question
Gardasil, the cervical-cancer vaccine, had higher reported rates of fainting and blood clots in patients who received the vaccine than those patients receiving other vaccines, but it doesn't appear to raise the risk of certain severe adverse events, according to a new safety analysis.

Separately, an article published in JAMA criticized Merck's marketing of Gardasil, including the company's funding of education campaigns by professional medical associations, which the authors said didn't provide a balanced view of the vaccine.

The two articles bring to the forefront questions about the safety, effectiveness, and marketing of Gardasil; these issues have existed since the vaccine's 2006 introduction.

The effectiveness of the vaccine has been questioned since its regulatory approval was for protecting against two strains of cancer causing human papilloma virus, or HPV, but not all cancer-causing strains. The vaccine was tested only in a few hundred 11- and 12-year-old girls, which some say was too small a number to declare it safe for that age group.

The CDC and FDA analyzed more than 12,400 reports of adverse events reported from more than 23 million doses of Gardasil. About 6% of the reported events resulted in hospitalization, permanent disability, or death. Of nearly 1,900 reports of fainting, 200 resulted in falls that caused head injuries including fractures and dental injuries. Blood clots were less common, occurring 56 times, according to the study. They included four deaths due to pulmonary embolisms. But the authors say the clot data should be viewed with caution because 90% of those with clots had other risk factors, such as being smokers or using oral contraceptives.

Rick Haupt, program lead for HPV vaccines at Merck's research arm, said the study supports Merck's view that Gardasil has "high efficacy" and a "favorable safety profile."
http://online.wsj.com/article/SB125062519949640947.html?mod=dist_smartbrief

Healthcare Communication
Hugman B.
London, UK: Pharmaceutical Press
2009; Price $49.95; Paperback

Communication is a vitally important part of the daily activities of all healthcare providers. This book is an interactive and engaging guide to establish professional, practical, and rewarding relationships that will support therapy and enhance patient health, safety, and morale.

The book provides:

• Information to gain a deeper knowledge and understanding of relationships and communications
• Examples and suggestions of how and what to do in healthcare relationships, especially involving patients
• Tips for managing difficult people and on establishing effective teams and running productive meetings
• Exercises for practice, entertaining illustrations, and quotations

The 26 chapters are entertaining and educational. This book is recommended for students, technicians, and pharmacists to enhance their communication skills.

Medium-Chain Triglycerides (MCTs)

Uses: Solvent, emulsifying, and suspending agent

Composition: Consists of a mixture of triglycerides of saturated fatty acids, mainly of caprylic acid and of capric acid. It contains not less than 95% of saturated fatty acids.

Description: A colorless to slightly yellowish oily liquid that is practically odorless and tasteless and solidifies at about 0�C.

In a Drug Topics "Letter" this month, Dr. John Colaizzi discusses whether or not we need more pharmacy schools. In citing a presentation by ACPE at the APhA annual meeting, he states that between 1955 and 1975 the number of U.S. pharmacy schools remained stable at 72 schools. It is now reported that between 127 and 138 schools will either have accreditation or be in the process of achieving it in the next two years. This is a potential 97% increase in the number of schools since 1975 at a time period in which the U.S. population has only increased about 40%.

Smile!
There have been several television clips demonstrating the effect of a "smile" on others as you walk down the street. The same scenario works in your pharmacy as you approach your patients and smile when you say, "May I help you?"