July â¢ August 2003 - Ontario College of Pharmacists

July/August 2003 

New Precursor Control Regulations 

created to address 

drug diversion in Canada

Council Members 

Council Members for Districts 1-17 are listed below 

according to District number. PM indicates a public 

member appointed by the Lieutenant-Governor-in- 

Council. DFP indicates the Dean of the Faculty of 

Pharmacy, University of Toronto. 

1 Marie Ogilvie 

2 Vacant 

3 Oluremi Ojo 

4 Reza Farmand 

5 Larry Hallok 

6 Alexander Wong 

7 Leslie Braden 

8 Iris Krawchenko, Vice-President 

9 Larry Boggio 

10 Gerry Cook 

11 David Malian, President 

12 Sabih Uddin 

13 Donald Stringer 

14 Stephen Clement 

15 Gurjit Husson 

16 Albert Chaiet 

17 Shelley McKinney 

PM Russell Carrington 

PM Garry Dent 

PM Bob Drummond 

PM Dean French 

PM Tina Gabriel 

PM Steve Gupta 

PM Katherine Hollinsworth 

PM Mel Jones 

PM Stephen Mangos 

PM Linda Robbins 

PM Michael Schoales 

PM Christina Weylie 

DFP Wayne Hindmarsh 

Statutory Committees 

• Executive 

• Accreditation 

• Complaints 

• Discipline 

• Fitness to Practice 

• Patient Relations 

• Quality Assurance 

• Registration 

ONTARIO COLLEGE OF PHARMACISTS 

M I S S I O N S T A T E M E N T 

The mission of the Ontario College of Pharmacists is to regulate the practice 

of pharmacy, through the participation of the public and the profession, in 

accordance with standards of practice which ensure that pharmacists 

provide the public with quality pharmaceutical service and care. 

Some of you may be questioning if you 

really need to maintain your practice 

license given how you spend your time. If 

you are retired or working in a position 

removed from pharmacy practice with no 

intention of ever practicing again, but wish 

to stay connected with the profession you 

contributed to for many years, you may be 

interested in the College’s 

Member Emeritus Roll. 

Standing Committees 

• Finance 

• Professional Practice 

Special Committees 

• Communications 

• Standards of Practice 

Working Group 

• Structured Practical Training 

• Task Force on Primary 

Health Care Reform 

• Working Group on Certification 

Examination for Pharmacy Technicians 

• Working Group on Pharmacy Technicians 

Members who voluntarily resign from the 

OCP Register after serving 25 years or more 

as a registered pharmacist, in any 

jurisdiction, and are in good standing, are 

entitled to become a Member Emeritus. 

On the Member Emeritus Roll, you have no 

practice privileges, you pay no fees, but 

you will continue to receive Pharmacy 

Connection and other select member 

notifications from the College. You will also 

receive a certificate indicating your status 

as a Member Emeritus with the College. 

If you meet the criteria for 

emeritus membership, 

please send a letter to the 

College noting that you 

wish to resign your active 

practice license and indicate 

that you wish to become a 

Member Emeritus.

Ontario College of Pharmacists 

483 Huron Street 

Toronto, ON Canada M5R 2R4 

Telephone (416) 962-4861 

Facsimile (416) 847-8200 

www.ocpinfo.com 

David Malian, B.Sc.Phm., CAE 

President 

Deanna Williams, B.Sc.Phm. 

Registrar 

Della Croteau, B.S.P., M.C.Ed. 

Editor and 

Deputy Registrar/Director of Programs 

Layne Verbeek, B.A. 

Associate Editor 

contents 

President's Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 

OCP Council Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6 

Precursors to Illicit Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 

Precursors Control Regulations Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . .14 

Q&A Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 

2003 Suspensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17 

Quebec Ontario Memorandum of Understanding . . . . . . . . . . . . . . . . . . .18 

International Pharmacy Graduate Program . . . . . . . . . . . . . . . . . . . . . . . .20 

Q&A SPT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21 

Health Canada Notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 

Inspectors’ Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 

Close Up on Complaints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 

Coroner’s Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 

Deciding on Discipline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32 

Pharmacy Practice Breakfast Series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 

Focus On Error Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 

Point of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 

Bulletin Board . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41 

CE Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 

Agostino Porcellini 

Graphic Designer 

Suzanne McLoughlin 

Copy Editor 

Alice Wlosek 

Distribution 

ISSN 1198-354X 

© 2003 Ontario College of Pharmacists 

Canada Post Agreement #40069798 

Undelivered copies should be returned 

to the Ontario College of Pharmacists. 

Not to be reproduced in whole or in part 

without the permission of the Editor. 

Subscription Rates 

In Canada, $48 + GST for six issues/year. 

For international addresses, $60. 

Subscription rates do not apply to pharmacists, 

students, interns and certified pharmacy technicians 

registered with the Ontario College of Pharmacists. 

Pharmacy Connection 

The objectives of Pharmacy Connection are 

to communicate information on College 

activities and policies; encourage dialogue 

and to discuss issues of interest with pharmacists; 

and to promote the pharmacist’s role 

among our members, allied health professions 

and the public. 

We publish six times a year, in January, March, 

May, July, September and November. We 

welcome original manuscripts (that promote 

the objectives of the journal) for consideration. 

The Ontario College of Pharmacists 

reserves the right to modify contributions as 

appropriate. Please contact the Associate 

Editor for publishing requirements. 

We also invite you to share your comments, 

topics suggestions, or journal criticisms by 

letter to the Editor. Letters considered for 

reprinting must include the author’s name, 

address and telephone number. The opinions 

expressed in this publication do not necessarily 

represent the views or official position 

of the Ontario College of Pharmacists.

PRESIDENT’S 

MESSAGE 

Dave Malian 

President 

Ireceive many calls from members 

across the province asking about 

the College’s programs and services, 

the decisions that our Council 

makes, and most frequently, offering 

advice about how the College should 

be run. Most of these calls are positive 

in nature; however some are more 

negative and critical of the College’s 

actions. This is especially true when a 

member calls in response to reports of 

a pharmacist who has been the subject 

of a public complaint or a disciplinary 

hearing and decision. 

I welcome such dialogue as I 

believe it’s vital for our members to 

express their concerns on issues they 

see as directly affecting patient care 

and pharmacy practice in Ontario. The 

College is always receptive to new 

ideas and suggestions because it is our 

members who collectively determine 

how pharmacy practice is regulated 

and what programs and services will be 

needed to uphold the highest possible 

standards for our profession. 

Yet how can this best be accomplished? 

And how can we ensure that 

the public is well protected and that 

members who come before the 

complaints or discipline process are 

given the appropriate resolution and/or 

decisions that will encourage self 

improvement and deter future 

misdeeds through our legislated regulatory 

role? 

Complaints and Discipline 

Philosophy 

The College recently held an informal 

session of the Executive, Complaints 

and Discipline committees to discuss 

these very important questions and to 

re-examine how we handle complaints 

and discipline to better meet the needs 

of today’s pharmacist while continuing 

to protect the public. The session went 

extremely well and it generated many 

new ideas that I believe will better 

serve both the public and our 

members. Overall, the group believes 

that the College’s approach to 

complaints and discipline must 

become more remedial than punitive 

to better protect the public. I 

encourage you to continue to express 

your views on this very important 

subject with your elected pharmacist 

Council member. 

Patient Praise 

I also periodically receive calls or letters 

from patients commending their pharmacist 

and highlighting the important 

role that their pharmacist plays in the 

management of their diseases. 

Recently, I got such a letter from a 

patient praising pharmacists at the 

White Cross Dispensary in Ottawa. 

The patient wrote, “Aside from 

their professionalism, their warmth and 

compassion makes dealing with them 

an oasis in the relative desert of health 

care in Ontario of late. They demonstrate 

that the corner-store pharmacist 

is still available and caring.” 

It’s my pleasure to receive letters of 

this kind because it’s an example of the 

type of pharmacist that practices in 

Ontario. I also know that letters of this 

sort could come from patients from any 

one of the 2768 Ontario pharmacies — 

as we all endeavour to put our patients’ 

health and well being first. 

I congratulate both the pharmacists 

of White Cross Dispensary and all 

pharmacists in Ontario who practice 

our profession with the highest standards 

of pharmaceutical care. The 

College’s role is to continue to license 

pharmacists who are knowledgeable, 

well trained and caring health care 

professionals who can service the 

needs of all Ontarians. I am confident 

that the College’s mandate to regulate 

pharmacy in the best interests of the 

public is well served. 

4 

Pharmacy Connection July • August 2003

Come out and vote in Districts 2, 6, 12 and 15 

As well, the following districts had acclamations: 

3: Oluremi Ojo, Toronto 

9: Larry Boggio, Port Colborne 

16: Albert Chaiet, Toronto 

An election ballot will be sent to the home addresses of all Part A and B 

pharmacists in districts 2, 6, 12 and 15. 

All ballots must be received at the College by August 6, 2003 

Pharmacy Connection July • August 2003 5

COUNCIL 

OCP COUNCIL REPORT 

JUNE 2003 

Strategic Plan 

Approved 

As reported in the March/April 

issue of Pharmacy Connection, 

Council held a strategic planning 

retreat in late March. At the 

session, Council agreed on five 

key strategic directions for 

College-focused activity over the 

next three to five years. 

The strategic directions were 

augmented by goals and rationale 

and then commended to the 

College management team to 

develop action plans with 

assigned responsibilities and 

timelines. The final report, 

Strategic Plan 2003, was considered 

and approved by Council in 

June. As before, the plan will 

serve as the foundation for 

College decisions respecting its 

activities, resource allocation and 

budgeting for each year. The 

complete Strategic Plan 2003 is 

available on our website. 

The strategic directions are: 

1. Address the impact of technology 

on the College’s 

regulatory role 

2. Continue to communicate the 

value of pharmacists and the 

services they provide to the 

public, government and 

healthcare professionals 

3. Explore and implement strategies 

to assist in the optimum 

supply of pharmacy human 

resources 

4. Consider an enhanced and 

expanded role for pharmacists 

5. Continue to effectively meet 

core mandate of self regulation, 

including exploring new 

approaches, in a fiscally 

responsible manner 

Council Member Reimbursement 

By-law 

Amended 

Council approved a recommendation 

from the Finance 

Committee to increase the 

expense allowance for elected 

members attending College business 

outside of their home 

district. The Finance Committee 

examined both the reimbursement 

model and the 

reimbursement amounts allowed 

under the by-law. Council agreed 

with the Committee’s recommendation 

that the College maintain 

the existing reimbursement 

model, namely: Council member 

contributions are essentially a 

volunteer service with no provision 

for income replacement. 

However, Council agreed that the 

allowance provided for expenses 

(that are reasonably incurred) 

should be increased as rates have 

not been adjusted for 15 years and 

accommodation costs in the 

Toronto area have significantly 

increased. 

OCP Professorship in 

Pharmacy Practice 

Council approved a proposal 

presented by Dr. Wayne Hindmarsh, 

Dean, Leslie Dan Faculty 

of Pharmacy, to establish a 

Professorship in Pharmacy Practice. 

The professorship is an 

opportunity for the College to 

join the profession in supporting 

the expansion and growth of the 

faculty while providing benefit to 

the College and its members 

through advancement in areas of 

pharmacy practice study. 

Council was informed that, 

while the Faculty initially 

proposed College-funding for a 

room or other identifiable 

element of the new Faculty 

building, the Executive 

Committee considered this to be 

inconsistent with the College’s 

mandate but nonetheless wanted 

to show support to the Faculty (as 

has every other organization affiliated 

with pharmacy in Ontario). 

The OCP Professorship in 

Pharmacy Practice will achieve 

6 


COUNCIL 

this goal by helping the Faculty 

retain an outstanding scholar and 

educator who will research to 

advance pharmacy practice. The 

OCP Professorship endowment 

requires a one-time contribution 

of $500,000, payable over five 

years. The endowment will be 

associated with, and bring benefit 

to, the College and its members 

in perpetuity. 

Member Emeritus 

Eligibility Expanded 

Council supported a change to 

the eligibility criteria for Member 

Emeritus status where members 

who have practiced continually in 

good standing in Ontario and/or 

other jurisdictions for at least 25 

years are now entitled to join this 

honorary roll. This adjustment 

was prompted by changes in the 

profile of College registrants and 

recognizes the mobility of 

members between jurisdictions. 

Guidelines for 

Reporting Incapacity 

Council has approved a set of 

reporting guidelines, in response 

to many members’ questions 

about how to report colleagues 

who may be incapacitated*. 

These guidelines were developed 

as an attempt to provide guidance 

to members on their obligations 

as they relate to a colleague who 

is, or is suspected to be, incapacitated. 

These guidelines will be 

printed in a future edition of 

Pharmacy Connection. 

In conjunction, Council also 

reviewed information about the 

Ontario Medical Association’s 

Physician Health Program which 

provides monitoring and followup 

to assist incapacitated 

members to return to their workplace. 

Council supported the 

need to formalize its approach in 

rehabilitating incapacitated 

members and, accordingly, 

College staff are studying this 

program and discussing a possible 

collaborative approach with the 

Ontario Pharmacists’Association. 

“‘Incapacitated’ means, in relation 

to a member, that the 

member is suffering from a 

physical or mental condition or 

disorder that makes it desirable 

in the interest of the public that 

the member no longer be 

permitted to practise or that the 

member's practice be 

restricted.” Section 1(1), Health 

Procedural Code, RHPA. 

Competency Profile 

for the Proposed 

Registered Pharmacy 

Technician 

After two years of extensive 

development, consultation and 

feedback, Council approved the 

Competency Profile for the 

proposed regulation of pharmacy 

technicians. This initiative 

focuses specifically on establishing 

a new class of registration 

with the College – the Registered 

Pharmacy Technician. Council 

set this priority in 1998 to create 

a class of support personnel with 

a defined level of responsibility 

and accountability that could 

assist pharmacists in meeting 

their standards of practice and 

focusing on patient care. 

The Competency Profile 

serves as a framework to allow 

the College to proceed with the 

next stages in the process. The 

competencies are an essential 

basis to developing entry-to-practice 

requirements, standards of 

practice, legislative changes, and 

eventually, continuing competency 

programs for technicians 

— all of which will be required 

by the provincial government to 

create a new class of registration. 

The complete competency 

profile will be published in the 

September/October issue. 

Loyalty Points 

Council adopted a new policy 

position on loyalty programs. This 

policy, which takes effect on 

January 1, 2004, prohibits the 

awarding of loyalty/bonus points 

or air miles on any prescriptions, 

prescription services or professional 

services related to 

pharmacy practice in Ontario. 

The College position is based 

on Section 29 of the Professional 



COUNCIL 


Misconduct Regulation, namely: 

“Offering or distributing, directly 

or indirectly, a gift, rebate, bonus 

or other inducement with respect 

to a prescription or prescription 

services.” 

The matter of loyalty programs 

has been before the College for 

several months, with a review 

being prompted both by external 

requests for review and internal 

concerns respecting ongoing 

enforcement challenges resulting 

from different interpretations of 

the existing policy and causing 

confusion in the marketplace. 

It is Council’s position that 

offering loyalty points, air miles 

or other incentives to induce 

patients to have prescriptions 

filled at more than one pharmacy 

is inconsistent with the current 

pharmaceutical care model that 

promotes high-quality care 

through long-term pharmacistpatient 

relationships. The 

College has long supported the 

view, shared by many health care 

professions, that it is in the 

patient’s best interest to find (and 

stay with) one health care 

provider, and in our case, one 

pharmacy, that best meets the 

patient’s health care needs and is 

the custodian of all the patient’s 

health information. 

Council also acknowledges 

current trends to support an 

enhanced role for the pharmacist 

in primary care reform and 

payment for cognitive services, 

and considers this revised policy 

to be in keeping with these 

trends. The College has also 

expended significant resources 

on public communication initiatives 

to help shift the public’s 

perception of the pharmacist and 

it believes that this new policy is 

consistent with this objective. It 

is vital for the public to see pharmacists 

more as health care 

professionals than retailers and 

that they view prescriptions more 

as important and serious entities 

necessary for their health than 

simple commodities or products. 

The new policy is: 

1. Bonus points, loyalty points or 

air miles may not be awarded 

on prescriptions, prescription 

services, or other professional 

services related to the practice 

of pharmacy in Ontario. 

2. Points may not be redeemed, or 

used as legal tender, for the 

purchase of prescriptions. 

3. Prescriptions, prescription 

services, or other professional 

pharmacy services may be paid 

by a major credit card that is 

linked to awards, loyalty points 

or air miles through special 

agreements with financial 

institutions, except where 

directly or indirectly, a special 

gift, bonus, or other 

inducement is offered to a 

prescriptions, prescription 

services or other professional 

pharmacy services. 

4. This policy does not affect the 

College’s current position 

respecting pharmacies and 

parking charges. Pharmacies 

that reimburse parking charges 

(for a client who is having a 

prescription filled) are not in 

violation of current regulations 

(professional misconduct), as 

long as such reimbursement is 

not advertised. 

Council additionally, agreed 

that the current advertising regulation 

and related issues 

respecting prescription services, 

such as inducements, soliciting 

and waiving of co-payments, 

need to be reviewed. 

In an effort to inform pharmacists, 

designated managers 

and owners, a notice with this 

new policy was faxed to all pharmacies 

in June. As well, owners 

and directors of pharmacy chains 

are being invited to meet with the 

College for an information and 

question and answer session on 

the new policy. 

8 


NOTICE 

Don’t Forget….. 

The next Pharmacy Technician 

Certification Examination will be 

held on Monday, October 20, 

2003. 

Once a pharmacy technician has 

been deemed eligible to sit the 

examination, the College will send 

the “Application to Write the 

Pharmacy Technician Certification 

Exam” package. 

Your application must be received at 

the College, with the appropriate fee 

of $233.26 (GST included) by no 

later than September 15, 2003. 

Check our website www.ocpinfo.com 

for CE and other resources. 

For your information, the following 

are forthcoming: 

Aug. 24 – Oct. 5: Toronto 

Certification Review for Pharmacy 

Technicians – 2003 

Humber College 

Sundays from 9 am to 4 pm 

Aug. 24, Sep. 7, 14, 21, Oct. 5 

tel: (416) 675-5000 

Oct. 24: Ottawa 

Pharmacy Technician Conference: 

Pharmacy - To Serve & Protect 

Ottawa Hospital, General Campus 

Kim Lamont 

tel: (613) 737-8899, x 72585 

fax: (613) 737-8891 

klamont@ottawahospital.on.ca 

Oct. 24-25: Listowel 

Technicians 2003 Current Topics 

for Pharmacy 

Listowel Memorial Hospital 

Chris Vanderspiegel 

tel: (519) 291-3125, x 231 

fax: (519) 291-5440 

chris.vanderspiegel@hphp.org 


COVER STORY 

Precursor Control 

The prevalence of illicit synthetic drugs such 

as methamphetamine, ecstasy, P2P and 

other amphetamine-type stimulants has 

become increasingly widespread in Canada and 

beyond. As a result, governments around the 

world are working to reduce the diversion of 

precursor chemicals, drugs and compounds that 

are used in illicit drug production. 

A number of countries, including the U.S., 

have enacted legislation to help regulate the movement 

of precursors and to prevent diversion. While 

the U.S. has already placed strict restrictions on 

the use and sale of precursor drugs and chemicals, 

Canada has, as a result, become home to many 

clandestine labs as it did not have any regulations 

to restrict the sale or movement of precursors. 

You may have read April news reports about a 

10 


COVER STORY 

Greg Ujiye, B.Sc.Phm. 

Manager, Pharmacy Practice Programs 

Regulation Now in Effect 

huge seizure and subsequent arrests across Canada, of 

pseudo-ephedrine tablets destined for the U.S. for use in the 

illicit methamphetamine production. 

New Canadian Regulation 

Last year, the federal government created the Precursor 

Control Regulation under the Controlled Drugs and 

Substances Act (Regulation) to provide a regulatory framework 

that enables Canada to fulfill its international 

obligations and to address domestic concerns in monitoring 

and controlling access to precursors. 

Two classes of precursors, Class A and Class B, have 

been established. Class A precursors are essential components 

of illicit substances, such as methamphetamine, 

MDMA (ecstasy), cocaine, heroine, LSD, and PCP. Class 

B precursors are mostly solvents and reagents used in 

clandestine manufacturing processes. (See summary 

sheet for list of precursors and implementation schedule 

on page 14.) 

This regulatory framework will govern the international 

and domestic movement of precursor chemicals and will 

allow local and national law enforcement agencies, including 

Canada Customs and Revenue Agency, to identify and 

control illicit drug production and traffic. 

Implementation Dates 

A phased-in approach is being implemented: The licence and 

permit requirement for import/export of Class A precursors, as 

well as the licence requirement for their production, came 

into force on January 9, 2003. Implementation controls over 

the domestic distribution of Class A precursors 

followed on July 7, 2003, when the 

licence requirement to sell or provide came 

into force. Controls over Class B precursors 

will be effective on January 1, 2004. 

The intent of this Regulation is to reduce the diversion 

of precursor chemicals. It will also limit the ability of criminal 

organizations to legally purchase these chemicals as 

well as reduce the potential pressure on legitimate businesses 

from organized crime operators to sell these 

chemicals. At the same time, these controls will increase 

public safety and reduce the harm and risks to the environment 

that result from the clandestine laboratory operations 

that dump chemical wastes. 

Nonetheless, difficulties in upholding these regulations 

lie in the fact that most precursors have wide and legitimate 

uses in such common products as pharmaceuticals, 

fragrances, flavouring agents, petroleum products and 

paints. This Regulation enables Canada to address the need 

to monitor and control precursors, while at the same time 

remain sensitive and responsive to the approved uses of 

these chemicals. 


COVER STORY 

Impact on Pharmacies 

Pharmacies are classed as general retailers whose commerce 

is not “limited to chemicals or related equipment” and who 

provide or sell Class A precursors only in quantities equal to 

or less than the thresholds specified in the Schedule to the 

Regulation. Therefore, pharmacies are exempt under section 

5 from the licence requirements for selling/providing. (The 

Regulation has the greatest impact on importers, exporters, 

manufacturers, producers and distributors of the precursors 

found in Class A.) 

Exemption 

Pharmacies are considered retailers/end users and as such 

will be minimally affected by the new regulation. Furthermore, 

pharmacies that sell products to the public containing 

precursors which fall under the threshold as defined in the 

Schedule to the Regulation will not be required to have a 

licence under the Regulation. The regulations are not 

intended to impede the use of these products for legitimate 

purposes. 

For example, pseudoephedrine-containing products will 

be limited to 3g per package size. Package sizes of 60 tablets 

containing 60mg of pseudoephedrine HCL/ tab or 30 tablets 

containing 120mg of pseudoephedrine HCL/tab are considered 

under the threshold. 

Licence Required 

However, pharmacies will be required to have a licence if 

they sell oversized products with more than 3g pseudoephedrine 

per package. Furthermore, selling or 

transfering quantities of product to another pharmacy or 

retailer is considered wholesaling and will require a licence 

as the exemption under section 5 of the Regulation would 

not apply. (Please refer to threshold limitations in the Regulations 

Summary chart at end of this article.) 

End-Use Declarations 

Purchases of oversized products or quantities over the 

threshold will require an End-Use Declaration (EUD) to be 

signed: 

1. An End-Use Declaration will be provided by the distributor 

and must be signed by a person acquiring the Class 

A precursor — before the transaction takes place 

2. The declaration is valid until the end of the calendar year 

from the date of the first transaction 

We are currently aware of the following products that fall 

into this category: CoActifed Syrup2 L, Coactifed Expectorant, 

Covan®, Cotridin Syrup and Cotridin Expectorant; 

there may be others. 

The distribution of Class A precursors in Schedule F are 

exempted from the application of the Regulations. Such 

examples include Trinalin® and Cafergot®. 

End-Use Declarations Effective July 7, 

2003 

As of July 7, 2003 pharmacists are required to sign EUDs 

when purchasing products over the threshold as defined in the 

Regulations from distributors. Pharmacists will also be 

required to prepare EUDs for selling over-limit quantities. 

However, there are transitional provisions for the 

package size stated in the schedule to the Regulation. For 

pharmacies and other retailers, the EUD requirement for 

selling over-limit quantities does not apply until October 9, 

2003 for all ephedra, ephedrine and pseudoephedrine products 

produced and packaged before October 9, 2002. 

12 


COVER STORY 

Information 

Office of Controlled Substances website: 

www.hc-sc.gc.ca/ocs-bsc 

(CDSA, guidance documents and application forms, 

up-to-date information and links) 

Pharmacies can sell any pseudoephedrine product manufactured 

before October 9, 2002 in any package size (100 

count pseudoephedrine HCL 60mg tabs) and still fulfill the 

exemption criteria under Section 5, until October 9, 2003. 

Reporting Suspicious Transactions 

Licensed dealers are required to record all suspicious transactions 

and are encouraged to report these to Health 

Canada. 

Although this requirement is applicable only to licensed 

dealers, pharmacists are asked to practice due diligence 

and are encouraged to report any suspicious transactions 

that occur. 

Health Canada encourages everyone, licensed dealers and 

non-licensed dealers, to report all suspicious transactions to 

the RCMP National Chemical Diversion Program. 

Royal Canadian Mounted Police 

Federal Services, “0” Division 

130 Dufferin Avenue 

London, ON 

N6A 5R2 

Canada Gazette website: 

http://canadagazette.gc.ca/partII/tempPdf/ 

g2-13621.pdf 

(Precursor Control Regulations) 

or 

Precursor Chemical Section 

Licences and Permits Division 

Office of Controlled Substances 

Drug Strategy and Controlled Substances 

Programme 

Healthy Environments and Consumer Safety Branch 

Health Canada 

A.L.3502A 

123 Slater Street, 2nd Floor 

Ottawa, ON K1A 1B9 

Telephone: (613) 946-1142 

Fax: (613) 941-5360 

Attn: Cpl. Brent Hill 

NCO I/C Chemical Diversion Program 

Tel: (905) 876-9848 

Cell: (905) 302-0369 

Fax: (519) 640-7255 


HEALTH CANADA 

Advisories & Notices 

REGULATORY REQUIREMENTS 

under the Controlled Drugs and Substances Act (CDSA) 

PRECURSOR CONTROL REGULATIONS (PCR) 

Domestic 

JANUARY 9, 2003 

CLASS 

Acetic anhydride 

N-Acetylanthranilic acid and its salts 

Anthranilic acid and its salts 

Ephedrine, its salts and any plant 

containing ephedrine or any of its salts 

Ergometrine and its salts 

Ergotamine and its salts 

Isosafrole 

Lysergic acid and its salts 

A PRECURSORS 

3,4-Methylenedioxyphenyl-2-propanone 

Norephedrine (Phenylpropanolamine) and its salts 

1-Phenyl-2-propanone 

Phenylacetic acid and its salts 

Piperidine and its salts 

Piperonal 

Potassium permanganate 

Pseudoephedrine and its salts 

Safrole and any essential oil containing safrole 

Acetone 

Ethyl ether 

Hydrochloric acid 

CLASS 

B PRECURSORS 

Methyl ethyl ketone 

Sulphuric acid 

Toluene 

COMING INTO FORCE DATES 

CLASS 

January 9, 2003 

A PRECURSORS 

- a licence is required to import, export, produce, and package 

- a permit is required to import, export and transit/transhipment 

- only a licensed dealer may apply for an import or export permit 

July 7, 2003 

- a licence is required to sell/provide 

LICENCE 

REQUIREMENTS 

• a licence is required to import, export, produce, package or sell/provide 

• an end use declaration is required when selling Class A precursors to non-licensed dealers in 

quantities or package sizes greater than the threshold in the schedule to the Regulations 1 

• it may take up to 75 days for processing applications, due to the criminal record check 

requirement 

EXEMPTION FOR 

SELL/ PROVIDE 

(SECTION 5) 

The individual or business 

• only sells/provides goods on a retail basis(selling goods for the purpose of end-use and not 

re-sale); 

• sells/provides a selection of goods that is not limited to chemicals/chemicals and equipment 

used in the chemical industry for the production, processing or storage of chemicals; 

• and sells/provides a precursor in a quantity or package size, per transaction, that does not 

exceed the threshold in the schedule to the Regulations. 

NOTE: If the individual or business sells precursors over the quantity or package size specified in 

the Schedule, they will NOT meet the requirements for this exemption1. 

14 

1 

Transitional provisions in Section 92 - Any package size for any ephedra, ephedrine and pseudoephedrine products produced and packaged before 

October, 9, 2002 is deemed to conform with: paragraph 5(1)(c), exemption for sell/provide; and section 8, end use declaration, until October 9, 2003.

CLASS 

A PRECURSORS 

INDIVIDUAL EXEMPTIONS 

Section 48, provides a process to exempt preparations and mixtures where the Class A precursor 

cannot be readily extracted or the product itself cannot be used in the production of a controlled 

substance 

GENERAL EXEMPTIONS 

COMING INTO FORCE DATE 

The following are exempted from the application of PCR: 

Fragrances or flavourings 

• containing no more than 20% total concentration of anthranilic acid, N-anthranilic acid, 

phenylacetic acid, piperonal or piperidine, AND is intended to be used in a food, drug cosmetic or 

household product; 

Formulated silicone products 

• containing 1% or less of acetic anhydride that is a sealant, adhesive, or coating; and 

Schedule F Drugs 

• domestic distribution (sell/provide) of drugs in dosage form that contain a Class A precursor 

listed in Schedule F to the Food and Drug Regulations. 

CLASS 

B PRECURSORS 

January 1, 2004 - a registration is required to import, export and produce for sale 

• a permit is required to export certain ClassB precursors to specific destinations 

• no permit is required to import Class B precursors 

• only a registered dealer may apply for an export permit 

REGISTRATION 

• it may take up to 75 days for processing applications, due to the criminal record check 

requirement 

• there are NO registration requirements for sell/provide 

SCHEDULE 

Class A Precursors Maximum Quantity Class A Precursors Maximum Quantity 

Acetic anhydride 1000 kg 3,4-Methylenedioxyphenyl-2-propanone 0 

N-Acetylanthranilic acid 1 kg Norephedrine (Phenylpropanolamine) 0 

Anthranilic acid 1 kg 1-Phenyl-2-propanone 0 

Ephedra 20 g/pkg Phenylacetic acid 1 kg 

Ephedrine 0.4 g/pkg Piperidine 0.5 kg 

Ergometrine 0 Piperonal 0.5 kg 

Ergotamine 0 Potassium permanganate 50 kg 

Isosafrole 0.5 kg Pseudoephedrine 3 g/pkg 

Lysergic acid 0 Safrole 0.25 kg 

INFORMATION RESOURCES 

The Precursor Control Regulations can be obtained from the Canada Gazette website: 

http://canadagazette.gc.ca/partII/tempPdf/g2-13621.pdf 

(under bookmarks SOR/DORS/2002-359 and 361) 

A series of guidance documents written as a companion to the Precursor Control Regulations to provide guidance on meeting the 

regulatory requirements under these Regulations, as well as application forms can be obtained from the Office of Controlled 

Substances website: 

http://www.hc-sc.gc.ca/ocs-bsc 

or by contacting the Office of Controlled Substances, Drug Strategy and Controlled Substances Programme, Health Canada, at: 

613-946-1142 

Copie en français disponible 

15

Q&A 

Q A& 

Q A 

Greg Ujiye, B.Sc.Phm. 

Manager, Pharmacy Practice Programs 

PRACTICE 

QHas the Drug and Pharmacies Regulation 

Act been changed to allow prescriptions 

from out of the province? 

This question refers to s. 158 of the DPRA which states: 

A pharmacist may dispense a drug pursuant to a written order 

signed by a physician or dentist licensed to practise in a 

province in Canada other than Ontario, if in the professional 

judgment of the pharmacist the patient requires the drug 

immediately, but such order shall not be refilled. 

In the strict legal sense, only prescriptions that the 

pharmacist believes that a patient immediately needs (in 

their professional judgement) can be filled. 

However, prescriptions written in other provinces have 

been an issue for Ontario pharmacists for some time — 

especially since Ontario patients often receive health services 

from a bordering province (Manitoba or Quebec). In 

these border community situations, pharmacists are 

expected to use their professional judgment to verify the 

authenticity of a prescription order and to ensure optimal 

patient care. Pharmacists are also expected to make their 

decisions in the best interests of the patient. 

The issue of cross-border fills was first considered by 

Council in June 1999. At that time, Council “approved in 

principle”, that amendments be made to the DPRA to 

accept transfers from pharmacists from any province in 

Canada and to fill prescriptions written by prescribers across 

Canada. All other provinces permit this practice. These 

amendments have not been approved nor adopted by the 

Ontario Government. 

The situation is further confused as the proposed 

amendments to the DPRA allowing pharmacists to fill 

prescriptions from other Canadian prescribers was, along 

with the new Proprietary Misconduct Regulations, published 

in the July-August 2002 issue of Pharmacy Connection for 

member and stakeholder feedback and eventual re-submission 

to the government. Please bear in mind that these 

regulations remain as proposals that still require government 

approval and adoption. 

QI wish to subdivide my pharmacy to 

permit me to operate a “lock and leave” 

pharmacy. What must I do? Do I need to 

inform the College? 

In 1997, Council approved a recommendation from the 

Accreditation Committee to amend the DPRA regulations 

that require members to notify the College whenever they 

intend to operate a subdivided or “lock and leave” pharmacy. 

As such, the pharmacy must be constructed to separate the 

dispensary and non-prescription drug products (Schedules 

II and III) from general merchandise (unscheduled products). 

College inspectors have found instances where changes 

have been made to pharmacies without the College being 

notified. Simply ticking the “lock and leave” check box on 

your annual Certificate of Accreditation renewal does not 

constitute proper notification to the College that you intend 

to operate a “lock and leave”. 

Notifying the College 

When you notify the College of your intent to implement a 

“lock and leave” operation, the College will: 

• Send you the requirements for operating a “lock and leave” 

pharmacy 

• Require your pharmacy’s designated manager or owner to 

sign and submit an updated floor plan 

16 


Q&A 

• Ensure that all relevant documentation is included in the 

pharmacy’s file so it can be later reviewed by a College 

inspector 

“Lock and Leave” Design 

The pharmacy must be constructed to ensure that the area 

can be locked and made inaccessible to the public when a 

pharmacist is not on the premises. 

• The barrier must be at least 2.44 metres (8 feet) hight and 

wide enough to render the area inaccessible (amended 

March 2001) 

• If the barrier does not extend to the floor, it cannot be more 

than 15 centimeters from the floor 

• All products must be at least one meter from the barrier if 

it is possible for a person to reach products either over the 

top, under the bottom, or through the barrier 

The barrier should be constructed so that front store staff 

can also access the back storage areas and staff facilities 

whenever the barrier is in place. Situations where such 

access can only be achieved by opening the barrier are in 

violation of the policy. In such situations the pharmacy is 

considered opened and unsupervised. 

No drugs in the Food and Drug Act, Controlled Drugs and 

Substances Act or National Schedules I, II, or III may be sold 

while the pharmacy is closed. As well, the pharmacy phone 

must not be answered during the absence of an on-duty pharmacist. 

Renovations 

Creating a “lock and leave” is considered a renovation. Any 

renovation where the physical structure of the pharmacy is 

changed must be reported to the College. These changes 

include moving or changing the size of the dispensary, 

moving or removing walls, or expanding or decreasing the 

size of the pharmacy. In these cases, the designated manager 

or owner must sign and submit an updated copy of the floor 

plan. 

All questions or notifications should be directed to Elaine 

Maloney at 416-962-4861 x 293 at the College. 

Suspensions 

2003 

Pursuant to Section 24 of the Regulated Health Procedural 

Code, the Registrar has suspended the following members’ 

Certificates of Registration for nonpayment of annual fees. 

As of June 13, 2003 

Deborah Lynne Appel 

Denise Nancy Baldwin 

Krista Anne Baragar 

Keith Bernard 

Emiko Michiko Bolton 

Larry Howard Broadfield 

Lori Lynn Brown 

Dante Pugay Buhain 

Ahmad Haiderali Ramji Charania 

Shu Ki (William) Chung 

Paul Morton Cutler 

Nigel Alistair Degruyther 

Job Steven Goulding 

Trudy Carly Huyghebaert 

Tariq Ijaz 

Woon-San Ip 

Ranbir Kaur (Randi) Kataria 

Michael Frederick Kemp 

Samuel Sadak Kolta 

Susan Kotlyar 

Kevin Peter Kowalchuk 

Linda Irene Kuber 

John Yuen Fai Lee 

Anna Fay Leong 

Aaron Troy Marchand 

Brendan Joseph McGinn 

Nazanin Mehin 

Shiu-Cheung Richard Ng 

Vinh Hung Nguyen 

Tanya Marie O'Brien 

Chiemezie Oti 

Eric Boakye Poku 

Lori Jean Power 

Sunita Rao 

Jane Elizabeth Royle 

Rosemary Sibanda 

Margaret Frances Smith 

Charlene Gabrielle Soulliere 

Peter John Walters 

James Stuart Watson 

Mary Katherine Wulff 

Lingling Xu 

Christelle Marie Zacharki 


FEATURE 

Chris Schillemore, B.Sc.Phm. 

Manager, Registration Programs 

Historic 

Agreement 

signed by 

Quebec and Ontario 

At a special ceremony in Montreal on 

May 7, 2003, the Ontario College of 

Pharmacists and L’Ordre des 

pharmaciens du Quebec signed a 

Memorandum of Understanding 

(MOU) that will enhance pharmacist 

mobility between our provinces. 

The signing of this agreement allows pharmacists 

licensed in Ontario or Quebec, who graduated from a 

Canadian Council for Accreditation of Pharmacy 

Programs (CCAPP) accredited program, to move more easily 

between the two jurisdictions. However, due to the way 

Quebec’s legislation is framed, the Ordre can only accept 

pharmacists under the terms of the MOU who graduated 

from a CCAPP-accredited program with a minimum of 125 

credits and who graduated five or fewer years ago. (This 

agreement also facilitates recognition for Quebec students 

currently enrolled in the bachelor of pharmacy program at 

the University of Toronto as their educational credentials 

will be recognized by the Ordre under this agreement.) 

Structured Practical Training 

The primary intent of this agreement is for both regulators to 

mutually recognize each other’s structured practical training. 

The structured practical training requirement in Quebec is 

18 


FEATURE 

currently 15 weeks versus 12 weeks in Ontario. Therefore, 

Ontario pharmacists moving to Quebec will be required to 

complete an additional three weeks of structured practical 

training while those coming to Ontario will not be required 

to complete any additional in-service training. 

Entry-to-Practice Requirements 

Each province maintains its requirements for entry-topractice 

as defined in the chart below. 

In addition, Quebec will be offering its courses on legislation 

and the Quebec health care system on the Internet 

— so Ontario candidates will be able to complete these 

courses prior to relocating to Quebec. As these courses 

were only previously offered once-per-year at the University 

of Montreal and Laval University, this accommodation will 

expedite licensure for Quebec-bound candidates. 

We are optimistic that the scope of this agreement will 

be expanded in the future as legislation changes are made, 

so that an even greater number of pharmacists will be able 

to move to Quebec or Ontario. 

With this agreement, Ontario now enjoys mobility 

enhancing agreements with all provinces — as it is also a 

signatory to the Mutual Recognition Agreement for Pharmacy 

in Canada, 2000 (MRA). The MRA outlines the 

conditions under which a pharmacist, who is licensed or 

registered in one Canadian jurisdiction, will have his/ her 

qualifications recognized by another Canadian jurisdiction. 

If you any questions about moving to another province, 

please contact the provincial regulatory authority in the 

jurisdiction to which you wish to move. 

Summary of Licensure Requirements for 

Ontario and Quebec -Licensed Pharmacists, May 2003 

Ontario Requirements for Licensure 

Have a valid licence with L’Ordre des 

Pharmaciens du Quebec 

Have obtained a bachelor degree from a 

CCAPP-accredited pharmacy program 

12-Week Structured Practical Training 

internship program 

Proof of reasonable fluency in 

English/French 

Appropriate documentation (proof of 

identity, sworn affidavit, letter of good 

standing, etc.) 

Proof of having passed the PEBC 

Qualifying Examination 

Proof of having passed the 

Pharmaceutical Jurisprudence 

Examination 

Québec Requirements for Licensure 

Have a valid licence with the Ontario College of Pharmacists 

Have a Bachelor of Science in Pharmacy degree provided it was obtained less 

than five years prior to making application for a permit [licence] in Quebec as 

a pharmacist— provided that the program for which the degree was issued had 

at least 125 credits and is accredited by the CCAPP (“Equivalent Degree”) 

15-Week Structured Practical Training internship program. The Ordre will 

recognize and give a 12-week credit to candidates who complete the OCP’s 

Structured Practical Training internship program 

Submit proof of fluency in French according to the requirements of the 

Charte de la langue francaise 

Appropriate documentation (proof of identity, sworn affidavit, 

letter of good standing, etc.) 

Successfully complete a three-credit course on legislation and deontology at 

University of Montreal or Laval University or any equivalent course 

acknowledged by the Ordre 

Successfully complete a two-credit course on the Québec Health System at 

University of Montreal or Laval University or any equivalent course 

acknowledged by the Ordre 

Successfully complete a three-hour program on emergency 

contraception prescribing 


IPG 

ENGLISH 

COMMUNICATION 

SUPPORT 

Christina Yurchuk B.A., M.Ed 

Janet Sio B.Sc.Phm., ESL Instructors 

International 

Pharmacy 

Graduate 

Program 

One of the biggest challenges for pharmacists 

who graduated outside Canada or the 

U.S., whose first language is not English, is to learn 

the language skills to communicate and counsel patients. 

Although all participants in the IPG program must meet 

the fluency requirements set by the Ontario College of Pharmacists, 

there remains a need to empower participants with 

the required professional communication skills to effectively 

practice pharmaceutical care. This need was the impetus 

behind the creation of an important component in our 

program: the “English for Specific Purposes” (ESP) curricula. 

After conducting a language task analysis of practicing 

pharmacists, it was determined that the greatest language 

need for internationally trained pharmacists was counselling 

on prescriptions. This was translated into a course called 

“The Language of Patient Counselling”, that provides specific 

language practice (particularly in listening and speaking 

skills) that is required to conduct an effective patient interview. 

This course is woven into the IPG program and 

reinforces concepts taught in other courses (i.e. Communications 

Course) and provides the language supports necessary 

for the student to be able to conduct the Professional Practice 

Labs, where participants are, in addition to dispensing, also 

assessed on their counselling skills. 

This new course was structured according to a 

communication model specific to the patient 

counselling interview. Through this course, 

participants learn to: 

• Establish rapport with the patient 

• Gather information to compile a patient 

profile 

• Provide relevant information in an organized and 

effective way 

• Express empathy when appropriate 

• Conclude the interview in a professional manner 

The language classes are divided into two parts: a) the 

practice phase (or pre-communicative phase); and b) the 

role-play phase with feedback (also known as a communicative 

phase). 

In the first phase participants have many listening and 

speaking opportunities to practice English in the context of 

pharmacy practice: grammatical structures, appropriate use 

of terminology, socio-cultural context of language, logic, 

sequence of questions, etc. In the second phase, participants, 

in groups of three, have the opportunity to role-play portions 

of, and eventually, the complete counselling interview. Each 

student has the chance to be the patient, the pharmacist and 

the observer. (The observer’s role is to provide feedback to the 

pharmacist.) 

continued on page 22 

20 


Q&A 

Q A& 

Q A 

Stephanie Edwards, B.Sc.Phm. 

SPT 

Diana Spizzirri, B.Sc.Phm. 

QDo pharmacy students need to be 

registered with the College? 

Students must be registered with the College to perform 

the “controlled acts” (e.g., dialoguing with patients, taking 

telephone prescriptions) while under the direct supervision 

of their preceptor or another pharmacist. 

This applies to both international pharmacy graduates 

doing SPT Studentship and to Canadian/U.S. students 

registered in non-credit studentship positions. (Note: There 

is no OCP studentship training requirement for students in 

accredited Canadian or U.S. faculties of pharmacy, as they 

receive experiential training through their existing curricula.) 

Furthermore, pharmacy students must identify themselves 

as “students” in any situation where they are 

performing the controlled acts. All OCP-registered pharmacy 

students are assigned an OCP student number and 

given an identification card that displays their status. 

Interns 

Interns must also be registered with the College to legally 

perform the controlled acts, first under supervision and 

then independently, once the preceptor agrees and a pharmacist 

remains present in the pharmacy. Preceptors are 

reminded that interns must receive notification from the 

College that their SPT Internship has been successfully 

completed. Furthermore, they cannot work alone until they 

are licensed. 

QIf the student must be supervised while 

performing the controlled acts, such as 

taking a verbal prescription by phone, 

how do you suggest this be done? 

This question is frequently raised at the preceptor workshops. 

The important thing is for you to give your student as 

much practice as possible in listening to, and transcribing, 

drug names and directions as well as noting people’s names 

over the telephone. You may allow the student to take “live” 

verbal prescriptions under direct supervision when you 

become comfortable with their ability. 

Some creative suggestions for providing students with 

opportunities to practice taking telephone prescriptions 

include: 

• Having a technician or pharmacist read prescriptions 

from hard copy files and then have the student review 

the written prescriptions to self-assess their accuracy 

• Asking a physician’s office to fax a copy of the 

prescription so the verbal order can be later verified 

• Having a physician assist by giving a verbal order to 

the student, and repeat and spell the details as 

necessary 

• Using a telephone system which allows two people to 

listen in on the line, have the student identify 

him/herself as a student before taking the prescription, 

while the pharmacist listens to verify the order. 



Q&A 

QI have heard that all interns are required 

to forward their completed Activities to 

the College. Is this true? 

Yes, effective 2003, all students and interns are required to 

submit their completed Activities to the College as part of 

their structured training. They will be notified by SPT staff 

approximately one month into the rotation. We suggest that 

you submit your Activities three weeks prior to the end of 

your rotation. 

Preceptors should discuss the Activities with the 

student/intern and review the final version before it is 

submitted. This will reduce re-submissions and expedite the 

overall licensing process. 

The College conducts in-house random reviews of 

completed Activities to ensure the SPT program is fairly 

implemented across all SPT sites. Although we do not 

review every report in detail, we do look for evidence that 

preceptors have provided necessary feedback to their 

student/intern and that the final submissions are high 

quality. Please refer to the guidelines for completing the 

Activities in the SPT manual. 

QHave there been any changes in the 

assessment process of SPT programs? 

Please note that the assessment process for the SPT 

programs has changed slightly in 2003. For Canadian/U.S. 

SPT Internship, one of the three monthly formal assessments 

has been replaced by a TOC or Target Objective 

Conference. The TOC is a brief, one-page assessment form 

to be completed by the student or intern along with their 

preceptor’s feedback that is added during the discussion 

with the student/intern. (Similar changes for international 

pharmacy graduates will be made in the near future.) These 

changes were made in response to preceptors who sought 

decreases to the workload and required paperwork. 

International Pharmacy 

Graduate Program 

All sessions are led by an ESL 

instructor and a pharmacist teaching 

assistant (TA). This co-facilitation 

provides participants with a unique 

learning opportunity. The pharmacist 

TA assists in what participants may say; 

addressing specific pharmacist-patient 

interactions such as counselling a specific 

dosage form. The ESL instructor assists in 

how they may say it; addressing specific linguistic 

issues such as grammar and phrasing. Moreover, 

because of the small group size (10-15 per group) there is an 

opportunity for each participant to receive tailored feedback on their language and counselling skills. 

Student response has been positive as they are reporting that the ESL course is giving them new confidence in 

conducting patient interviews. 

22 


HEALTH CANADA 

Advisories & Notices 

DATE 

June 9 / 03 

June 6 / 03 

June 4 / 03 

May 28 / 03 

May 27 / 03 

May 23 / 03 

May 9 / 03 

May 8 / 03 

April 29 / 03 

April 28 / 03 

April 14 & 17 / 03 

April 10 / 03 

April 2 / 03 

April 1 / 03 

March 18 /03 

March 12 / 03 

March 5 & 

February 28 / 03 






January 30 / 03 

TYPE 

Advisory – Health Canada reminds Canadians of the Dangers of Ephedra / ephedrine products 

Advisory – Health Canada is advising Canadians not to use Empowerplus. Also known as EM Power+ and EM 

Power sold by Truehope Nutritional Support Limited (also known as Synergy) 

Insulin Products in Canada – an update from Health Canada 

Important Safety Information on Estrogen Plus Progestin (PremplusTablets) – Wyeth Pharmaceuticals 

Warning – Health Canada warns the public not to use Hua Fo / VIGOR-MAX 

tablets, a Chinese herbal product that contains tadalafil. Inappropriate use of tadalafilcould cause severe 

adverse reactions 

Important Medical Devices Safety Advisory to users of Siemens Servo 300 / 300A Ventilators – Siemens 

Canada Limited 

Public Advisory – Bronchial Problems Associated with Rapamune® (sirolimus) – Wyeth Pharmaceuticals 

Advisory – Health Canada advises against the use of SEAVITE products containing iodine 

Advisory – Health Canada is advising Canadians to be wary of products with claims concerning the 

prevention or treatment of SARS 

Advisory – Health Canada is advising Canadians of a dangerous interaction between diathermy therapy and 

implanted metallic leads 

Important Safety Information & Public Advisory Regarding Permax ® (pergolide mesylate) and Cardiac 

Valvulopathy – Eli Lilly Canada Inc. and Draxis Health Inc. 

Important Safety Information & Public Advisory About DIANE ® - 35 and the Risk of Venous 

Thromboembolism – Berlex Canada Inc. 

Notice to Hospitals - Important Safety Information Regarding Diathermy Therepy – Health Canada 

Important Dosing Clarification for Fragmin® (dalteparin sodium injection) – Pharmacia Canada Inc. 

Advisory on Diethylstilbestrol (DES) and the Risk of Genital and Obstetrical Complications – Health Canada 

Important Safety Information Regarding Ethyol (Amifostine) and Severe Cutaneous Reactions – Health 

Canada 

New Safety Information Associated with the Use of Zoloft® (sertraline hydrochloride) in Patients taking 

Pimozide (Contraindication) – Pfizer Canada Inc. 

Advisory – Health Canada reports back to public on safety profile of Meridia ® (sibutramine) 

Warning Regarding Rapamune® (sirolimus) and Bronchial Anastomotic Dehiscence including Fatal Cases – 

Wyeth Pharmaceuticals 

Notice to Hospitals – Cochlear Implant Recipients may be a Greater Risk for Meningitis – Information Update, 

Health Products and Food Branch 

Letter to Healthcare Professionals Regarding Synagis® (pavlivizumab) – Abbott Laboratories Limited 

Advisory – Health Canada is advising Canadians about the safe use of products containing Acetaminophen 

New Contraindication Regarding Ergotamine and Dihydroergotamine – containing drugs: Risk of Cerebral 

and/or Peripheral Ischemia – Novartis Pharmaceuticals Canada Inc. 

For complete information and electronic mailing of the Health Canada Advisories / Warnings /Notices, 

subscribe online at: http://www.hc-sc.gc.ca/hpfb-dgpsa/tpd-dpt/ 


COLUMN 

INSPECTORS’ CORNER: 


THE INSPECTION PROCESS 

Rose Fitzgerald, B.Sc.Phm. 

“Inspection is not a game of "catch as catch can". Rather, as I noted, 

it is a process of verification for the purpose of creating confidence. 

It is not built upon the premise of trust. Rather, it is 

designed to lead to trust…” 

– Hans Blix, United Nations Weapons Inspector, January, 2003 

Each year, the College’s Pharmacy Practice 

Department receives many calls, and 

inspectors and staff are also approached 

by many pharmacists, all asking questions 

about the process and details of pharmacy 

site visits/inspections. 

While past articles have focused on the 

details of the inspections, this article 

provides an overview to provide you with 

a greater understanding of the inspection 

process; starting from the Prior 

Notice letter informing the designated 

manager of an upcoming inspection 

through to the possible outcomes of 

that visit. Future articles will discuss 

specific aspects of the inspection 

process such as “action plans”. 

There are over 2700 accredited pharmacies 

in Ontario. Each pharmacy receives a 

routine inspection once every three years. The 

College employs four inspectors and one compliance 

officer who are responsible for all inspections 

24 


COLUMN 

which include routine, re-inspections, new openings, 

acquisitions and relocations. 

Inspections should not be confused with investigations. 

Inspections fall under the jurisdiction of the Accreditation 

program area whereas investigations are the responsibility of 

the Investigations and Resolutions Department. The Drug 

and Pharmacies Regulations Act (DPRA) provides the 

College with the authority to appoint inspectors and the 

authority to inspect pharmacies and examine records. 

The Inspection process for a pharmacy is similar to 

the Quality Assurance Program for pharmacists. It is a 

form of practice review. The inspections are primarily 

educational and conducted to assist members in 

complying with legislative requirements for maintaining a 

practice site that allows for the safe distribution of drugs 

and for pharmacists to maintain professional and operational 

standards of practice. The College has also worked 

over the years to revise the inspection process so that it 

becomes a more positive experience by shifting the 

inspection focus from “checking the nuts and bolts” of a 

pharmacy to a broad review of how members practice in 

the pharmacy site. 

Unfortunately identifying deficiencies is viewed by 

some pharmacists as criticism or enforcement. While 

some pharmacists view the inspection as adversarial or 

negative, the underlying role of the inspector is to accurately 

and professionally identify deficiencies in the 

pharmacy and/or in its members’ practice. These deficiencies 

are brought to the attention of the designated 

manager and/or the owner. 

The inspectors are also available to answer questions 

about pharmacy practice, clarify issues and to make recommendations. 

The College and its inspectors work to provide 

the most suitable and constructive way to achieve the ultimate 

goal of inspection, namely, to ensure that every 

pharmacy complies with the legislation and standards and 

that pharmacists meet the Standards of Practice. 

Routine Inspections 

Every accredited pharmacy receives, at no cost, one inspection 

and one follow-up re-inspection (if required). 

Cost Recovery 

In the past, pharmacies that did not achieve compliance 

were re-inspected until compliance was achieved or until 

the pharmacy was referred to the Accreditation Committee 

for review and a possible further referral to the Discipline 

Committee for resolution. This process led to many delays 

from initial visit to a final resolution, and in some cases, it 

resulted in four or five pharmacy visits over a period of years. 

It was also found that, in most cases, the same pharmacies 

were responsible for several re-inspections and a more expeditious 

process was needed. 

In 2002, the Accreditation Committee believed that it 

was unfair for the majority of compliant pharmacies to pay 

for the few non-compliant locations and recommended that 

cost recovery charges be imposed on non-compliant locations. 

Effective January 2003, pharmacies that the 

Committee decides require an inspection beyond their original 

inspection and one re-inspection will now be required to 

pay $500 (plus GST) for all future visits. Costs can also be 

charged for inspections determined through an undertaking 

as a result of a Complaints hearing or can be ordered as part 

of a Discipline decision. 


COLUMN 



By better preparing for an inspection, the designated 

manager / owner will have more time to discuss any inspection 

or practice-related issues with the inspector. Some 

designated managers/owners like to be present during an 

inspection. Although inspectors do not schedule appointments, 

a request for the inspection to be held on a specific 

day of the week can be arranged when the inspector’s 

schedule permits it. 

Pharmacy Site Visit / Inspection* 

Inspectors try to avoid interfering with a pharmacy’s daily 

routine and usually request the use of an office or an area 

close to the main dispensing area. Once the inspection is 

completed, the inspector will generate a report for the designated 

manager to discuss any deficiencies identified. 

The Inspection Process 

The Prior Notice Letter Begins the 

Inspection Process 

When three years has elapsed from the last inspection, a 

Prior Notice letter is sent to the designated manager/owner 

advising him/her that an inspection will take place within 

the next 3 months. This allows ample time for the pharmacy 

to prepare for the inspection by: 

- Reviewing the inspection checklist 

- Reviewing library requirements 

- Checking record keeping 

(*The Pharmacy Site Visit is discussed in detail in the 

January/February 2003 issue.) 

Action Plan* 

When deficiencies are identified, the inspector will 

request an action plan, with a deadline, from the designated 

manager/owner. Any questions concerning the 

action plan should be discussed at that time with the 

inspector. You can also call the inspector with any followup 

questions. 

Action plans are filed and recorded at the College and 

become part of the pharmacy’s inspection record. (While 

the pharmacy will be reminded if the action plan is not 

submitted on time, failure to submit an action plan may 

result in a referral to the Accreditation Committee.) 

The inspector reviews the action plans and can either 

accept or deem the plan incomplete. In some instances, 

when a number of deficiencies are identified or a particular 

26 


COLUMN 

deficiency is extreme, the inspector may request a re-inspection 

of the pharmacy in addition to an action plan. 

*An article detailing the Action Plan will be published in a 

future edition. 

Pharmacy Re-inspection 

The goal of a re-inspection is to ensure that the pharmacy 

has achieved compliance. The re-inspection is handled 

much like a regular inspection with special attention being 

paid to the issues/deficiencies identified in the prior inspection. 

Re-inspections normally occur within one to six months 

(after the College receives the action plan) and are 

performed by the compliance officer. Re-inspections are not 

usually done by the original inspector so as to allow the 

pharmacy to be reviewed without bias. 

Pharmacies that fail to achieve compliance upon this reinspection 

are then referred to the Accreditation Committee 

for a decision. The designated manager will be asked to 

provide a detailed action plan for the compliance officer that 

is then forwarded to the Accreditation Committee, along 

with the pharmacy’s previous inspection history, for review 

and decision. 

Accreditation Committee 

The Accreditation Committee is a statutory committee 

under the Pharmacy Act comprising of pharmacist members 

of Council, non-Council pharmacist members and public 

members appointed to Council. One of the Committee’s 

duties is to address issues related to the Certificates of 

Accreditation of pharmacies that have failed to achieve 

compliance. 

In reviewing the inspection reports and any information 

provided by a pharmacy, the Committee can make the 

following decisions: 

1. Conclude the matter 

2. Request another re-inspection with costs 

3. Refer the pharmacy to the Discipline Committee 

4. Refer the pharmacy to the Discipline Committee and 

request an Interim Suspension of the Certificate of 

Accreditation 

5. Refer the owner/designated manager to the Executive 

Committee to recommend action 

Helping Pharmacists Achieve the 

Accreditation Standards 

For most pharmacies, the inspection process results in a 

successful report that the pharmacy has met the accreditation 

standards. Some pharmacies require multiple visits 

before compliance is achieved. Very few re-inspections 

result in a pharmacy being referred to the Accreditation 

Committee. 

The ultimate goal of the College is to provide advice and 

feedback to the designated manager and/or owner in order to 

achieve compliance for the pharmacy. 

If you have questions about a past or upcoming inspection, 

please feel free to contact your inspector. They will be 

pleased to assist you. 


COMPLAINTS 

CLOSE 

UP ON COMPLAINTS 

Altering Third Party 

Payor Information 

Acting Outside the Scope of the Pharmacist’s Role 

Eva Markowski, Complaints Officer 

The College frequently receives complaints from 

third-party payors about situations in which 

pharmacists acted outside their professional scope of 

practice by altering coverage data to assist patients 

in the processing of a claim. This article examines 

such a complaint and the Complaints Committee 

investigation and disposition. 

Facts 

A man attended a pharmacy and 

presented a third-party insurer card for 

two prescriptions. Upon entering information 

into the computer the 

pharmacist saw that, while the patient 

was not covered, the patient’s spouse 

was insured under the policy number. 

The patient insisted that he was 

covered and the pharmacist attempted 

twice more to process the transaction. 

Both attempts failed. A fourth attempt 

succeeded but only after the pharmacist 

altered the patient’s profile to 

indicate that he was the cardholder, 

rather than the spouse. The pharmacist 

then entered the cardholder’s date 

of birth. 

Although the patient received 

coverage under the plan, a few days 

later, the pharmacist’s alterations to the 

profile resulted in these transactions 

being assigned to the cardholder, not 

the patient. Documentation substantiating 

the transaction was provided to 

the College by the third party insurer. 

28 


COMPLAINTS 

Reasons 

The Complaints Committee reviewed 

the transaction records and determined 

that the member had violated 

his pharmacy’s standing protocol with 

the insurer by repeatedly submitting 

the patient’s prescription (despite the 

system’s failure to accept the transaction). 

The Committee appreciated the 

member’s willingness and intent to 

promptly fill the patient’s prescriptions; 

there were; however, there were 

more appropriate courses of action 

available to the pharmacist. The pharmacist 

could have: 

• Dispensed the medication as a 

cash purchase to the patient, 

knowing that the patient could 

be reimbursed once he proved 

that he was insured; or 

• Paused to phone the insurer to 

verify whether there was indeed 

a “glitch” in the system records 

that failed to note that the 

patient was covered 

The Committee did not consider 

this to be a situation where the pharmacist 

was exercising his 

“professional judgment” to override 

the system because the member has 

no discretionary permission to alter 

third party records or billings. 

It was highly inappropriate for the 

member to alter a record to force a 

transaction that would override an 

adjudication system. 

And, while the member’s motive 

may have been to accommodate his 

patient, his actions led to intentional 

and repeated re-submissions despite 

the computer system indicating 

“claimant not covered”. 

Decision 

Although the Committee concluded 

that the member had acted inappropriately, 

it struggled to determine a 

suitable disposition. Indeed, is 

referral to the Discipline Committee 

the only appropriate remediation for 

the member’s behaviour? 

After much discussion, the 

Committee decided that referral to 

the Discipline Committee would be 

inappropriate and that the member’s 

breach of the Standards of Practice 

would be appropriately addressed 

with the issuance of a written 

caution, which read: 

“As a practising pharmacist, you 

must maintain the standards of 

your profession and remain in 

compliance with the relevant 

legislation. While the Committee 

appreciates that you may have 

been attempting to accommodate 

your patient, you are cautioned 

that you are expected to fulfill 

your obligations to your patient 

without violating protocol and the 

standards of your profession, and 

are reminded here particularly of 

Standard 6 which reads: 

‘The pharmacist applies knowledge, 

principles and skills of 

management as they pertain to the 

site of pharmacy practice, with the 

goal of optimizing patient care and 

inter-professional relations.’ ” 

The Committee was of the 

opinion that another such incident 

was unlikely to occur in this 

member’s practice given: this was a 

single incident involving a minor 

amount of money for a patient who 

became insured within 4 days of the 

transaction; the member had no 

intent to mislead, and he provided a 

forthright response to the 

Committee. 

Nonetheless, although this 

complaint did not reveal any evidence 

of fraud by the member or the pharmacy, 

the College’s investigation did 

confirm that the third-party insurer 

should not have been billed and that 

the member had violated his pharmacy’s 

agreement with the insurer. 

The Committee therefore determined 

that a written caution 

adequately addresses the public 

interest raised in this complaint. The 

caution will remain on the member’s 

record in the non-public portion of 

the Register. 

WHAT IS A WRITTEN 

CAUTION? 

A written caution is often issued by 

the Complaints Committee as an 

appropriate remedial measure for 

serious matters where a referral to 

the Discipline Committee would not 

be appropriate. Although the member 

identified in a complaint is not 

required to appear before the 

Complaints Committee for his/her 

“caution”, the caution is included 

in the Committee’s written decision, 

thereby sent to the complainant as 

well as the member. It is also permanently 

placed on the member’s 

non-public portion of the Register. 

Although it is not considered punitive, 

the caution may be considered 

should the member appear before 

the Committee for a new complaint. 


REPORT 

CORONER’S REPORT 

CORONER’S REPORT 

The College regularly receives reports from the Ontario 

Coroner’s Office. Following is a summary of the findings of a 

recent case along with recommendations that have an impact 

on pharmacists and pharmacy practice. 

CASE 

KIMBERLY ANN ROGERS 

On August 9, 2001, Kimberly Ann 

Rogers, a 40 year-old woman who was 

eight months pregnant, was found 

dead in the apartment in which she 

was confined by terms of a sentence 

imposed for welfare fraud. Ms. Rogers 

had a history of depression with panic 

attacks, migraines and a disabling knee 

injury. As a result of her conviction, Ms 

Rogers had been temporarily ineligible 

for welfare benefits under the 

province’s “zero-tolerance” policy. 

There were many stresses in Ms 

Roger’s life including financial, legal, 

medical and occupational issues. 

While the coroner’s jury made 

several recommendations, the 

following summary only lists the relevant 

medical aspects of this case as 

information and education for pharmacists. 

A full report of the coroner’s jury 

can be obtained by contacting the 

Office of the Chief Coroner at 416- 

326-5010. 

Recommendation #5 to the 

Government of Ontario— 

Minister of Health and the 

College of Physicians and 

Surgeons 

“Physicians should be educated on the 

potential risks of tri-cyclic anti-depressants 

in the treatment of depression, and 

should be encouraged to use the safer 

class of anti-depressants such as SSRI’s 

as a first line drug therapy. Wherever 

appropriate, physicians should 

encourage patients to access supportive 

counselling services in the community.” 

Rationale: To encourage the use of 

extreme caution in the prescribing of 

medications, by encouraging the 

prescribing of a less dangerous or lethal 

drug. 

Pharmacists should also bear this 

information in mind and are encouraged 

to collaborate with physicians, 

patients and community services agencies 

to ensure optimal drug therapy. 

(The report also noted that this patient 

was pregnant and therapy was chosen 

with that consideration in mind.) Each 

refill of a prescription for antidepressants 

is an opportunity for the 

pharmacist to dialogue with the 

patient, to monitor any changes in drug 

therapy or the patient’s condition, and 

to determine whether the patient is 

accessing counselling services. 

30 


REPORT 

Recommendation #9 to the 




Surgeons 

“Consideration should be given to the 

creation of a computer access Internet 

program such as British Columbia’s 

PharmaNet system. For example by 

using a health card that would permit 

pharmacies to access a patient’s drug 

dispensing records from other pharmacies, 

as well as to alert other pharmacies 

of a patient’s past attempt to utter forged 

prescriptions. Pharmacists should be 

required to notify the prescribing physician 

of any attempts by the patient to 

alter the prescription.” 

Rationale: Evidences showed that 

several different pharmacies were used 

to fill prescriptions. This will give pharmacists 

a history of a patient’s 

prescriptions. 

Other coroner’s reports have 

recently made recommendations 

regarding a central data base of prescription 

and health information to aid 

pharmacists and other health professionals 

in providing optimal care to 

patients. Until such time a system is in 

place which provides this information, 

while protecting patient privacy, pharmacists 

need to continue to enter into 

dialogue with their patients, gather as 

much information as possible, identify 

any potential problems, and intervene 

in the best interests of the patient. 

Recommendation to the 




Surgeons 

“Physicians should be encouraged to 

write out prescriptions in both digits and 

longhand to prevent modification of the 

quantity by patients, e.g. “40, forty 

tablets”. 

Rationale: Evidence was introduced 

indicating possible quantity changes on 

the Physician’s prescription by the 

patient. This will prevent a patient from 

changing the numerically written 

number. 

Professional practice staff from 

OCP and the College of Physicians 

and Surgeons meet on an ongoing basis 

to discuss matters of mutual concern, 

such as the clarity of prescriptions. The 

College’s Executive Committee also 

affirmed the recommendation that the 

prescribing physician should be notified 

of any attempts by the patient to 

alter the prescription. 

College inspectors also continue to 

point out problems regarding forged 

prescriptions as they visit pharmacies. 

A recent article in the 

November/December 2002 issue 

(pages 24-26) provides guidelines on 

how you can identify a forgery and 

what actions to take in the event of a 

forgery being received at your pharmacy. 

Recommendation to the 


Minister of Health 

“Health Canada and the publishers of 

the Compendium of Pharmaceuticals 

and Specialties(CPS) should ensure 

that the information for both brand 

name drugs and generic drugs reflect the 

same information. For example, the 

current descriptive entries for Elavil® 

(brand name) and Amitriptyline 

(generic name), while the same pharmaceutical/medicine, 

are noticeably 

different with respect to dosage for outpatients.” 

Rationale: To provide doctors with 

accurate information in regards to 

dosage and side effects. 

Pharmacist need to stay current 

and be aware of dosage and side 

effect information. This recommendation 

has been forwarded to the 

CPhA as they publish the CPS. Pharmacists 

should also maintain a variety 

of references in their pharmacy so 

that they can verify these types of 

discrepancies as they often occur in 

daily practice. It is also a current 

requirement that all pharmacies have 

access to an OCP-approved drug 

information service. This and an upto-date 

reference library will greatly 

assist pharmacists in clarifying drug 

information and assisting physicians 

with patient care. 


DISCIPLINE 

DECIDING ON 

DISCIPLINE 

CASE 1 

Failure to Maintain Records as Required 

Member: Hilton Silberg, Dundas 

Hearing Date: February 27, 2003 

Mr. Silberg was found to have: 

• Failed to keep records as required respecting 

his patients 

• Contravened, while engaged in the practice of 

pharmacy, any federal or provincial law or 

municipal by-law with respect to the distribution, 

sale or dispensing of any drug or mixture 

of drugs 

The following Agreed Statement of Fact 

formed the basis of Mr. Silberg’s admission of 

professional misconduct. 

Facts 

The Complaints Committee referred two incidents 

to the Discipline Committee. In the first, 

Mr. Silberg dispensed 100 ASA Enteric 325mg 

tablets to a patient. The receipt for the transaction 

listed a doctor as the prescriber, but in fact, 

the prescription was not authorized until later 

when Mr. Silberg was able to contact a different 

doctor to confirm the prescription. Before the 

authorization was received, the medication was 

dispensed and charged to the Ontario Drug 

Benefit Plan. A written prescription is required in 

order to charge the ODB for the dispensed 

medication. 

In the second, Mr. Silberg’s pharmacy 

received a compound prescription for Sulfazine. 

Another pharmacist in his pharmacy prepared 

the Sulfazine to be dispensed to a patient. 

However, the medication was not dispensed 

from the pharmacy where it was prepared. 

Instead, the medication was delivered to a 

second pharmacy, not owned by Mr. Silberg, for 

dispensing to the patient. The second pharmacy 

relabeled the medication so that it was no longer 

apparent that the medication was compounded 

at one of Mr. Silberg’s pharmacies. Mr. Silberg 

did not have an Establishment License to fabricate, 

package/label, distribute, import or 

wholesale a drug as required by the Food and 

Drug Regulations in such circumstances. Mr. 

Silberg had no direct knowledge that the medication 

was being compounded at one of his 

pharmacies and then being transferred to a 

different pharmacy to be dispensed under that 

pharmacy’s label. 

Reasons 

The Committee noted that as designated 

manager, Mr. Silberg acknowledged his responsibility 

to the public and to the profession for the 

breaches of the practice of the pharmacy. 

However, given that the breaches were largely 

technical in nature, the Committee considered it 

appropriate for Mr. Silberg to complete remediation 

that is not burdensome and can be 

completed through take-home assignments. 

Order 

1. A reprimand 

2. Mr. Silberg’s Certification of Registration shall 

be subject to specified terms, conditions and 

limitations, and in particular, that Mr. Silberg 

complete successfully, at his own expense 

within six months of the date of this order, 

remedial training in the form of take-home 

written assignments, from the Canadian 

Pharmacy Skills Program, namely: “Law 

Lesson 4 – Standards of Practice” and “Law 

Lesson 7 – Professional Liability” 

32 


DISCIPLINE 

DISCIPLINE 

CASE 2 

Failure to Take Appropriate Care When Dispensing 

Coumadin ® to a Patient; Failure to Obtain Requisite 

Authority to Dispense a Reduced of Quantity 

Member: Abdulkader Zalgaonker, Hespeler 

Hearing Date: February 27, 2003 

Mr. Zalgaonker was found to have: 

• Failed to maintain a standard of practice of the profession 

• Contravened, while engaged in the practice of pharmacy, 

federal or provincial law or municipal by-law with respect 

to the distribution, sale or dispensing of a drug or mixture 

of drugs 

The following Agreed Statement of Fact formed the basis 

of Mr. Zalgaonker’s admission of professional misconduct. 

Facts 

Mr. Zalgaonker is an owner, director, designated manager 

and dispensing pharmacist at his pharmacy. 

The patient was prescribed 250 Coumadin® 1mg 

tablets with directions to take two and one-half tablets 

once a day. Mr. Zalgaonker dispensed Coumadin® 5mg 

tablets in a container indicating that the contents were 

Coumadin® 1mg tablets. As a result, the patient 

consumed 12.5mgs of Coumadin® each day that she 

took the drug instead of the 2.5mgs that were 

prescribed. She suffered internal bleeding and was 

hospitalized for three days. 

In addition, the pharmacy records confirmed that the 

physician authorized three repeats of 250 Coumadin®. On 

some of these occasions, Mr. Zalgaonker reduced quantities 

without authority. 

Mr. Zalgaonker explained that the quantity of the 

prescription was reduced from 250 to 100 tablets to 

accommodate the limited personal budget of the patient 

and that he did not reduce the quantity for financial gain 

(which was marginal). Mr. Zalgaonker recognizes that the 

patient’s written authorization for the reduced quantities 

being dispensed would have been required in these 

circumstances. 

Reasons 

In accepting the Joint Submission on Penalty, the 

Committee considered that Mr. Zalgaonker has practised for 

20 years without any dispensing error complaints, and that 

since this incident Mr. Zalgaonker has developed new 

storage procedures for Coumadin® in the pharmacy by 

maintaining separately marked boxes for each strength and 

has revised his dispensing protocols to prevent future errors. 

The Committee also took into account that Mr. 

Zalgaonker was previously found guilty of professional 

misconduct by the Discipline Committee in June, 1999 in 

connection with a conviction for income tax evasion by his 

pharmacy business for the years 1992, 1993, 1994 and 

1995, contrary to the Income Tax Act. 

Order 


2. Specified terms, conditions and limitations on Mr. 

Zalgaonker’s Certification of Registration and in particular, 

that Mr. Zalgaonker complete successfully, at his 

own expense and within twelve months of the date of this 

order, the following: 

i) Courses offered through the Canadian Pharmacy 

Skills Program: “Law Lesson 6 - Standards of Practice” 

and “Law Lesson 7 - Professional Liability” 

ii) “Confronting Medication Errors” offered by the 

Ontario Pharmacists’ Association, including 

“Module 1, Understanding the Issues and Dealing the 

Incidents” and “Module 2, Taking Action to Improve 

Patient Safety” 

3. A suspension for a period of two months; one month of 

the suspension to be remitted on condition that Mr. 

Zalgaonker completes the remedial training workshops, 

courses and evaluations described in paragraph 2 above 

4. Costs to the College in the amount of $2,000 


DISCIPLINE 

CASE 3 

Failure to Ensure That Appropriate Systems Were in 

Place to Assure Accurate Delivery of Medication to A 

Patient; Failure to Appropriately Dispose of Drugs 

Returned to Stock 

Member: Gerald Friesen, Thunder Bay 

Hearing Date: March 14, 2003 

Mr. Friesen was found to have: 


• Returned to stock or again sold or dispensed a drug previously 

sold or dispensed and delivered 

• Engaged in conduct or performed an act relevant to the 

practise of pharmacy that, having regard to all the circumstances, 

would reasonably be regarded by members as 

disgraceful, dishonourable or unprofessional 

The following Agreed Statement of Fact formed the 

basis of Mr. Friesen’s admission of professional misconduct. 

Facts 

A pharmacist at Mr. Friesen’s pharmacy filled a prescription 

for 100mL Hydrocortisone suspension 1mg/mL (a 

compound prescribed for congenital adrenal hyperplasia) 

for a child patient. The prescription was then placed in a 

refrigerator for delivery the next day. The dispensing pharmacist 

also filled a prescription for Methadone for another 

client, which was stored in the same refrigerator as the 

Hydrocortisone compound. 

In error, the Methadone was packaged for delivery to 

the child instead of the Hydrocortisone compound. The 

child’s mother received the package, poured the medication 

into a teaspoon and was about to administer the medication 

to the child when she noticed by its content that it was not 

the correct medication. She then read its label which indicated 

that the medication was Methadone prepared for 

another patient. The mother notified the pharmacy 

regarding the packaging error. Mr. Friesen personally delivered 

the Hydrocortisone compound to the mother and 

retrieved the Methadone. 

Mr. Friesen returned to the pharmacy and placed the 

Methadone back in the refrigerator. He did not set the 

bottle aside or take other precautions to ensure that the 

Methadone was not re-dispensed to the wrong patient. The 

Methadone was relabelled to reflect the day’s date and was 

then dispensed to the patient it was intended for. 

Reasons 

The Committee believes the Joint Submission on Penalty 

was appropriate for the following reasons: 

• Mr. Friesen pleaded guilty and immediately accepted 

responsibility for the errors, saving the College undue 

cost and expense of investigation 

• In 34 years of practice in Ontario, this was Mr. 

Friesen’s first appearance before the Discipline 

Committee 

• The initial packaging error was made by an unknown 

pharmacy employee and Mr. Friesen, as the designated 

manager, accepted responsibility for the error 

• Mr. Friesen accepted full responsibility for returning 

to stock and re-dispensing the Methadone solution 

• Prior to the hearing, Mr. Friesen, on his own accord, 

attended and completed the Methadone Treatment 

Workshop provided by the Centre for Addiction and 

Mental Health. The workshop included seven hours of 

instruction, including the fundamentals of methadone 

maintenance, counselling of methadone patients, pharmacy 

issues, urine drug screens and an overview of 

substance use disorders 

• While there was potential for patient harm, none in 

fact occurred 

• Mr. Friesen has modified his practice by designating a 

separate refrigerator for storing methadone 

The panel notes that dispensing errors concerning 

methadone, as well as other narcotic and controlled 

substances, may lead to very serious consequences and 

urges the member to exercise extreme caution when 

dispensing these substances. 

34 


DISCIPLINE 

DISCIPLINE 

Order 


2. Specified terms, conditions and limitations on Mr. 

Friesen’s Certificate of Registration, and in particular, 

that he attend at and participate in the education 

program, “Confronting Medication Errors”, offered by the 

Ontario Pharmacists’Association, including: “Module 1, 

Understanding the Issues and Dealing with Incidents” and 

“Module 2, Taking Action to Improve Patient Safety” 

3. One month’s suspension of Mr. Friesen’s Certificate of 

Registration, the suspension to be remitted on condition 

that Mr. Friesen complete the remedial training exercise 

specified above 


Charging an Excessive Fee 

CASE 4 

Member: Abe Kucyi, Toronto 

Hearing Date: April 24, 2003 

Mr. Kucyi was found to have: 

• Charged a fee that is excessive in relation to the service 

provided 


practise of pharmacy that, having regard to all the circumstances, 


disgraceful, dishonourable or unprofessional 


basis of Mr. Kucyi’s admission of professional misconduct. 

The Facts 

Mr. Kucyi dispensed Lupron Depot Ampkits® (3.75 mg) to 

a patient on eight occasions and the total cost of each of 

these transactions ranged between $431.84 and $461.09. 

Mr. Kucyi advised the College that for “about one 

year”, his pharmacy’s pricing policy was a dispensing fee of 

$11.99 with a mark-up of 30 per cent, regardless of cost. 

Six of the eight dispensing fees charged to the 

complainant were $12.68, not $11.99. Moreover, for the 

seven transactions for which drug supplier invoices were 

produced for the College by Mr. Kucyi the “mark-ups” 

ranged from about 30 per cent to 47 per cent. 

Reasons 

In accepting the Joint Submission on Penalty, the 

committee considered the fact that Mr. Kucyi cooperated 

with the College and entered a plea of guilty, saving the 

time and expense of a lengthy hearing. The Committee also 

noted that Mr. Kucyi has a prior disciplinary record from 

August 26, 1999, which also involved overcharging for 

prescriptions. 

Order 


2. One month’s suspension of Mr. Kucyi’s Certificate of 

Registration 


Insurance Fraud 

CASE 5 

Member: Harit Kumar Nathwani, Waterloo 

Hearing Date: April 24, 2003 

Mr. Nathwani was found to have: 


• Failed to keep patient records as required 

• Falsified a record relating to his practice 

• Signed or issued in his professional capacity, a document 

that he knew to contain a false or misleading statement 

• Submitted an account or charge for services that he knew 

was false or misleading 

• Breached the Drug and Pharmacies Regulation Act and 



The Pharmacy Practice Department invites you to breakfast 

to meet with your College inspector and your peers. 

This is your opportunity to discuss College policies, 

pharmacy practice and general issues that affect your 

day-to-day practice in an informal atmosphere. 

2003 Pharmacy Practice 

Breakfast Series 

As A Participant, You Choose the Topics for Discussion 

The meetings are structured to allow you to select topics of your choice in advance 

(Standards of Practice, inspection process, professional judgment, etc.) Where possible 

other staff or invited guests from the Practice Area or College will attend. 

There will also be sufficient time for questions and answers. The inspectors will remain 

after the meeting to continue discussions with those who wish to stay. 

Let us Know if You Want a Meeting in Your Community 

Invitations will be mailed to all pharmacies in each selected area (within 30 minutes 

driving distance) 30-45 days prior to the meeting. Held at a local restaurant, each 

breakfast meeting will be limited to about 20 participants at no cost. As space is 

limited, firm commitments will be accepted on a first come, first served basis only. 

We will also ask one local pharmacist to act as a liaison between his/her local 

colleagues and the attending field inspector. A reminder will be sent by fax to the 

pharmacy one week prior to the meeting. Breakfastwill be served from 7:00 a.m. with 

the meeting portion running from 7:30 a.m. to 8:30 a.m. 

For more information, or to arrange a meeting in your area, please contact your 

OCP inspector or Barb Church at the College at (416) 962-4861 x. 236. 

We look forward to hearing from you! 

36 


DISCIPLINE 

DISCIPLINE 

regulations there under 


practice of pharmacy that, having regard to all the circumstances 


disgraceful, dishonorable or unprofessional 


basis of Mr. Nathwani’s admission of professional misconduct. 

Facts 

Mr. Nathwani was the owner, designated manager and 

dispensing pharmacist of Northfield Pharmacy. Through a 

series of random provider service audits, Green Shield 

discovered that claims were being submitted by Mr. Nathwani’s 

pharmacy, and paid by Green Shield, when no 

medication was actually provided to the patients. Green 

Shield provided subscriber confirmation letters from 

patients who denied receiving prescriptions related to 

claims made in their name by Northfield Pharmacy. 

The College contacted two of the eight patients in question 

who verified that they did not receive the medication as 

claimed by Northfield Pharmacy. The College also met with 

a physician who denied prescribing three prescriptions 

attributed to her by Northfield Pharmacy. 

Reasons 

The Committee considered the undisputed fact that Mr. 

Nathwani’s conduct was a deliberate attempt to defraud a 

third-party insurer and to create records to cover up the 

fraud. The misconduct occurred over a 10-month period of 

time and involved 34 prescriptions, eight subscribers and a 

total of $1,438.83. Mr. Nathwani did not provide the 

Committee with any explanation for his conduct other than 

to express shame and regret. 

In concluding that the penalty is fair, reasonable and 

consistent, the Committee considered that Mr. Nathwani 

had no prior discipline record, as well as the fact 

that its penalty affirms the seriousness of Mr. Nathwani’s 

misconduct in a real and immediate sense. At the same 

time, the penalty provides Mr. Nathwani with an opportunity 

to rehabilitate while also providing necessary 

public protection. 

Order 


2. Specified terms, conditions and limitations on Mr. Nathwani’s 

Certificate of Registration, and in particular, that 

Mr. Nathwani complete successfully, at his own expense, 

within 12 months of the date of this order, the OCP 

Jurisprudence Seminar as well as remedial training in 

the following courses and evaluations from the Canadian 

Pharmacy Skills Program: “Law Lesson 2 – The 

Regulation of Pharmacy Practice”, “Law Lesson 4 – Standards 

of Practice”, and “Law Lesson 7 – Professional 

Liability” 

3. A six-month suspension of Mr. Nathwani’s Certificate 

of Registration 

4. Additional specified terms, conditions and limitations 

on Mr. Nathwani’s Certificate of Registration, and in 

particular that, for a period of one year following the 

completion of his suspension, (December 01, 2003 – 

November 30, 2004): 

i) Mr. Nathwani is prohibited from having any proprietary 

interest in a pharmacy, in any capacity 

ii) Mr. Nathwani cannot act as a designated manager 

in any pharmacy 

iii) Mr. Nathwani must inform all employers in a pharmacy 

setting of the full details of the decision of the 

Discipline Committee and ensure that they 

confirm their information with the College directly 

iv) Mr. Nathwani’s employment remuneration shall be 

based only on hourly or weekly rates and his 

employer(s) are to confirm this arrangement in 

writing with the College 



COLUMN 

F O C U S 

O N 

Error Prevention 

Counselling Patients on Pre 

brand of the drug. The tablets were therefore labelled 

NovoPurol® 100mg. The following day, Mr. Smith 

continued to take his regular medication including Apo 

Allopurinol 100mg along with what he believed to be a new 

drug NovoPurol® 100mg. 

Ian Stewart, B.Sc.Phm. 

Though the pharmacist may dispense the right drug at 

the right dosage, patient education is critical in 

ensuring that the right patient takes the right dosage 

of the right drug at the right interval. As the following cases 

illustrate, lack of patient education may lead to drug administration 

errors. 

CASE 1 

Mr. Smith, a 70-year-old patient, regularly takes the 

following medications. 

Drug 

Apo Allopurinol 100mg 

Avapro® 150mg 

Apo Atenolol 50mg 

Dose 

Once daily 

Once daily 

Once daily 

Recently, Mr. Smith received a new three-month 

prescription of Allopurinol 100mg from his physician. On 

this occasion, the pharmacist dispensed the Novopharm 

A few days later, Mr. Smith requested a refill of his Apo 

Allopurinol 100mg tablets. On questioning the patient 

regarding the need for an early refill, the pharmacist learned 

of the misunderstanding and as a result, the doubling of the 

prescribed dosage of Allopurinol. 

Possible Contributing Factors: 

• The patient was unaware of the relationship between Apo 

Allopurinol and NovoPurol® 

• The patient did not question the physician or the pharmacist 

regarding his ‘new’ therapy 

• Appropriate counselling did not take place when NovoPurol® 

was dispensed 

Recommendations: 

• Always review the patient’s medication history prior to 

counselling 

• Educate your patients regarding the relationship between 

brand names and generic names — this is especially 

important when switching brands. In these instances, 

place a sticker or note on the prescription bag to remind 

the pharmacist/yourself of the need to counsel the patient 

• Encourage your patients to ask questions, especially when 

they notice something different about their prescription/medication 

38 


COLUMN 

scription Renewals/Changes 

CASE 2 

Mr. Jones, a 60-year-old patient has been taking Novo 

Fenofibrate Micro 200mg capsules prescribed by his family 

physician. In an effort to better control his cholesterol levels, 

Mr. Jones was then referred to a specialist. Following an 

assessment, a prescription was written for Lipidil Supra® 

160mg to be taken once daily. 

Assuming that Lipidil Supra® 160mg is a different drug 

to be added to his medication regimen, Mr. Jones decided to 

take both drugs together. However, his wife convinced him 

to first check with the pharmacist who confirmed that the 

Novo Fenofibrate Micro should be discontinued. 

Possible Contributing Factors: 

• Neither the specialist nor the pharmacist provided any 

information regarding the discontinuation of Novo Fenofibrate 

Micro 

• The patient was unaware that the generic name of both 

drugs is Fenofibrate 

Recommendations: 

• Always review the patient’s medication history to identify 

potential drug related problems 

• Encourage your patients to also learn the generic names of 

the drugs being taken 

Please note the College’s generic or “single entity” drug policy: 

Please ensure that your pharmacy’s dispensary software is 

set to label these drugs according to this policy. 

Title: Generic Prescriptions 

Date of Council Report: January 1980 

a) The preferred method of labelling all prescriptions for single-entity 

drugs is that they be labelled using the 

non-proprietary (generic) name of the drug, plus the 

name of the manufacturer, and 

b) Particular care should be taken when labelling generically-written 

and 'product-selected prescriptions' — that 

is when the brand name is prescribed but the generic is 

dispensed. In these cases, the pharmacist should use 

the generic name, plus the name of the manufacturer, 

and not the trade name. 

Editor’s Note: 

Both of these errors may have been prevented with appropriate patient counselling. Some pharmacists believe that the standard is that they only 

counsel on a new prescription, and only on that prescription. These cases emphasize the need for pharmacists to evaluate the entire patient profile 

whenever a medication is dispensed. Operational Component 1.2 of the Standards of Practice includes “The pharmacistreviews relevant information 

from the patient profile with each new prescription, change of prescription, and repeat prescription.” Operational Component 1.3 outlines the role of 

the pharmacist in evaluating drug therapy and identifying potential and actual drug-related problems. 


Shoppers Drug Mart 

HARROW 

If you are interested in including 

the Point of Care symbol in your 

permanent pharmacy signage, 

please contact the Communications 

Department for an electronic copy 

of the artwork. You may also go 

online to www.ocpinfo.com and 

Main Drug Mart 

TORONTO 

select "Point of Care" to view the 

graphic usage standards. 

Comber Drug Store 

COMBER 

40 


B U L L E T I N B O A R D 

Class 7T3 30th Reunion 

We will be returning to the Fern 

Resort in Orillia Sept 19-21, 2003. 

For information please contact 

Tom/Liz Betts (905) 945-9078, Bill 

Dingwall (905) 475-1395, Vera 

Smith (705) 326-8290. 

Class of 7T8 25th Reunion 

Our 25th Pharmacy Reunion is planned for 

October 3-5, 2003 at Nottawasaga Inn Resort in 

Alliston. The American Plan rates for a 2-night stay 

(accommodation, meals, gratuities) are $136 per 

person/night-double occupancy and $189 per 

person/night-single occupancy (plus taxes). 

For information on the resort and all its amenities 

(golf, tennis, swimming, etc.) please visit 

www.NottawasagaResort.com 

Reserve your room with the Resort’s Group Reservations 

Department for the “U of T Faculty of Pharmacy 

Reunion” before Friday, July 4, 2003 at (416) 364-5068 

or (905) 939-2220 or (705) 435-5501 or 1-800-669- 

5501. The Saturday Evening Reunion Banquet-only is 

also available. 

Please express your interest by forwarding your 

email and home addresses with phone numbers to Doris 

Kalamut (Hallmann) 35 Anderson Avenue, Toronto, 

M5P 1H5 (416-485-2067) or dkalamut@rogers.com. 

Class of 9T8 5th Reunion 

The five-year class reunion will be held this fall at the 

Nottawasaga Inn, October 3-5 2003. There will be a 

variety of activities at the resort during the weekend and 

a banquet on Saturday evening. For more information 

contact Stacie Harley at stacie_harley@hotmail.com, 

(416) 413-9196 or Jessy Samuel at 

Jessy.Samuel@moh.gov.on.ca. Hope to see you there! 

Upcoming Practice Review Dates 

Practice Reviews will be held at the 

College on the weekends of September 

13-15, and November 29, 30, 

December 1, 2003. Pharmacists considering 

undergoing the Practice Review in 

order to move from Part B to Part A of the 

Register can contact the College at 416-962- 

4861 for details. 

Welcome to the College 

Shabniz Jaffer joined the College in March as Program 

Secretary, Continuing Competence Programs. Shabniz 

has extensive experience in various administrative roles. 

Most recently she was with the Bank of Montreal, 

working with two vice-presidents in the e-business division. 

Recent Marriages 

Congratulations to Maria Beck (now Maria Earley) who 

surprised us all when she eloped with her husband 

Darren and to Shelliann Sterling (now Shelliann Harris) 

who travelled to Jamaica, with her husband Leon, for 

her special day. The staff would like to wish Maria and 

Shelliann all the best in the years to come. 

Alumni Death 

John Hassard, B.Sc.Phm. passed away on May 31, 

2003, the evening he was going to receive his 50-year 

Alumni certificate. Hassard, who practiced in Tilbury, 

Cobourg and Toronto is survived by three sons and a 

sister. 

PRECEPTOR WORKSHOPS 

Preceptor Orientation Workshops: 

Wednesday, August 6 

Thursday, Sept 11 Preceptor Advanced Workshops: 

Tuesday, Oct 7 

Wednesday, Sept 17 (Intercultural 

Communication/IPG Program) 


CE EVENTS 

Visit the College’s website: www.ocpinfo.com for a complete listing of 

upcoming events and/or available resources. A number of the 

programs listed below are also suitable for pharmacy technicians. 

Sep. 11-13: Toronto 

CLEAR Conference 

The Council on Licensure 

Enforcement and Regulation 

(CLEAR) 

web: www.clearhq.org 

Sep. 12-14: Toronto 

HIV/AIDS Patient Care - Level 1 

Certificate Program 

Ontario Pharmacists’Association 

Vaughan Estates 

Karen Cameron 

tel (416) 441-0788, x 4235 

kcameron@ontpharmacists.on.ca 

web: www.opatoday.com 

Paula Ferreira 

tel (416) 785-2500, x 2363 

fax (416) 7785-4215 

e-mail: pferreira@baycrest.org 

Sep. 19-21: Alliston 

55th Annual General Meeting and 

Education Sessions 

Canadian Society of Hospital 

Pharmacists - Ontario Branch 

Nottawasaga Inn 

Patricia Fontana 

tel (905) 804-4927 

fax (905) 277-3556 

Oct. 17-19 and Nov. 7-9: Toronto 

Certified Geriatric Pharmacist Preparation 

Course, (Parts 1 & 2) 

Ontario Pharmacists Association 

the Institute for Learning 

Karen Cameron or Sandra Winkelbauer 

tel (416) 441-0788, x 4235 

fax (416) 441-0791 

kcameron@ontpharmacists.on.ca 

or swinkelbauer@opatoday.com 

web: www.opatoday.com 

Sep. 18: Newmarket 

Emerging Treatment Strategies in 

Mood and Anxiety Disorders 

York North Pharmacists’Association 

and Janssen-Ortho 

Janet Shore 

tel (905) 841-4423 

fax (905) 853-0571 

Sep. 18: Toronto 

Fall Educational Evening and 28th 

Annual General Meeting 

Ontario Respiratory Care Society 

Greater Toronto Region, 6th Floor 

Fell Pavilion, Room 103 

Toronto Western Hospital 

Sheila Gordon-Dillane 

tel (416) 864-9911, x 236 

fax (416) 864-9916 

e-mail: orcs@on.lung.ca 

Sep. 19: Toronto 

Medication Use in the Geriatric 

Population, 

Baycrest Centre for Geriatric Care, 

Joseph E. & Minnie Wagman Centre 

Upcoming Live CE Event 

Physician-Pharmacist Collaboration – To Optimize Patient Care 

The workshop format of this event provides learning interaction through the 

application of case studies related to cardiovascular health. When you 

attend, you can expect: 

• Small group of 15 to 18 participants to permit personalized learning 

• An equal number of physicians and pharmacists from the same community 

to promote strengthened professional relationships for the long term 

The workshop is moderated by a physician-pharmacist team who will guide 

you through specially designed case studiesrelated to cardiovascular health. 

Learning Objectives 

On completion of the workshop, you will be able to: 

• Explain how closer physician-pharmacist collaboration improves 

patient care 

• Discuss the key components of effective physician-pharmacist 

communication 

• Use communication techniques to optimize communication between 

physicians and pharmacists 

• Use the knowledge acquired during the session to work out collaborative 

initiatives that could be used in a practice setting 

A Communimed program, this workshop will roll out in the Fall of 2003. 

42 


O C P M A N U A L - June 2003 

Each issue of Pharmacy Connection includes an up-to-date summary of all current OCP Manual items in the table shown. These items are available 

and can be printed off from our website: www.ocpinfo.com. Individual copies, or complete sets of the legislation (with binder and tabs), can also 

be ordered from the College. The OCP Manual, sold with the OCP Policy Handbook (complete with index and copies of reference articles), is $85 

($90.95 with GST). Sold separately, the OCP Manual is $64.20 (GST included) and the OCP Policy Handbook is $32.10 (GST included). 

Drug and Pharmacies Regulation Act (DPRA) * 

Amended 2000 

Regulations to the DPRA: 

DPRA R.R.O. 1990, Regulation 545 – Child Resistant Packages 

DPRA R.R.O. 1990, Regulation 547 Amended to O.Reg. 548/93 – Dentistry 

DPRA Ontario Regulation 297/96 Amended to O.Reg. 180/99 – General 

DPRA R.R.O. 1990, Regulation 551 Amended to O.Reg. 179/99 – General 

DPRA R.R.O. 1990, Regulation 548 Amended to O.Reg. 705/93 – Medicine 

DPRA R.R.O. 1990, Regulation 550 Amended to O.Reg 550/93 – Optometry 

Ontario Drug Benefit Act (ODBA) & Regulations * 

Amended 2002 

Regulations to the ODBA: 

Ontario Regulation 201/96 Amended to O.Reg. 395/02 – General 

Food and Drugs Act (FDA) & Regulations ✝ 

Updated Health Canada Version as of Dec. 19, 2001 

Amendment 1248-Iburprofen-Jan. 31, 2002 

Drug Schedules ** 

Summary of Laws Governing Prescription Drug Ordering, Records, Prescription 

Requirements and Refills - January 2001 OCP 

Canada’s National Drug Scheduling System – May 26, 2003 NAPRA (or later) 

Controlled Drugs and Substances Act (CDSA) ✝ 

Updated NAPRA Version as of October 25, 2000 

Benzodiazepines & Other Targeted Substances Regulations-Can.Gazette June 21/00 

Precursor Control Regulations – Can.Gazette October 9/02 

Regulated Health Professions Act (RHPA) * 

Amended 2002 

Regulations to the RHPA: 

Ontario Regulation 39/02 -Certificates of Authorization 

Ontario Regulation 107/96 – Controlled Acts 

Ontario Regulation 59/94 – Funding for Therapy or Counseling for Patients Sexually 

Abused by Members 

Pharmacy Act (PA) & Regulations * 

Amended 1998 

Regulations to the PA: 

Ontario Regulation 202/94 Amended to O.Reg. 548/99 – General 

Ontario Regulation 681/93 Amended to O.Reg. 122/97 – Professional Misconduct 

Standards of Practice ▲ 

New Standards of Practice, January 1, 2003 OCP 

Narcotic Control Regulations ** 

Updated NAPRA Version as of October 25, 2000 

OCP By-Laws By-Law No. 1 – June 2003 ▲ 

Schedule A - Code of Ethics, May 1996 

Schedule B - Conflict of Interest Guidelines for Members of Council and 

Committees - Oct 1994 

Schedule C - Member Fees - Jan 1, 2003 

Schedule D - Pharmacy Fees - Jan. 1, 2003 

Schedule E – Certificate of Authorization – Jan. 2003 

Reference ▲ 

Handling Dispensing Errors, Pharmacy Connection Mar/Apr 1995 

Revenue Canada Customs and Excise Circular ED 207.1 

Revenue Canada Customs and Excise Circular ED 207.2 

District Excise Duty Offices - Oct. 10/96 

Guidelines for the Pharmacists on “The Role of the Pharmacy Technician” 

Drug Interchangeability and Dispensing Fee Act (DIDFA) & Regulations * 

Amended 1996 

Ontario Regulation Reg. 935 - General 

Ontario Regulation Reg. 936 – Notice to Patients 

Regulations to the DIDFA: 

Regulation 935 Amended to O.Reg. 394/02 – General 

Regulation 936 Amended to O.Reg. 205/96 – Notice to Patients 

* 

** 

Information available at Publications Ontario (416) 326-5300 or 1-800-668-9938 

Information available at www.napra.org 

✝ Information available at Federal Publications Inc. Ottawa: 1-888-4FEDPUB (1-888-433-3782) 

Toronto: Tel: (416) 860-1611 • Fax: (416) 860-1608 • e-mail: info@fedpubs.com 

▲ Information available at www.ocpinfo.com 

C O L L E G E 

Registrar’s Office x 243 

urajdev@ocpinfo.com 

Deputy Registrar/Director of Programs’ 

Office x 241 

ltodd@ocpinfo.com 

Director of Finance and 

Administration’s Office x 263 

lbaker@ocpinfo.com 

Registration Programs x 250 

dbyer@ocpinfo.com 

Registration Information 

Surnames A-L: x 228 

jsantiago@ocpinfo.com 

S T A F F 

Registration Information 

Surnames M-Z: x 232 

jmckee@ocpinfo.com 

Structured Practical Training 

Programs x 297 

Pharmacy Practice Programs x 293 

emaloney@ocpinfo.com 

Pharmacy Openings/Closings x 227 

jsandhu@ocpinfo.com 

Pharmacy Sales/Relocation x 227 

jsandhu@ocpinfo.com 

Investigations and Resolutions x 272 

rpearson@ocpinfo.com 

Continuing Education Programs x 251 

cpowell@ocpinfo.com 

Pharmacy Technician Programs: 

Surnames A-L: x 228 

jsantiago@ocpinfo.com 

Surnames M-Z: x 232 

jmckee@ocpinfo.com 

Publications/OCP Manual x 229 

lgrant@ocpinfo.com 

Membership x 237 

rstarr@ocpinfo.com

Volume 10, Number 4 

www.ocpinfo.com 

www.worthknowing.ca

July â¢ August 2003 - Ontario College of Pharmacists

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July â¢ August 2003 - Ontario College of Pharmacists