Pepin's Pharmceutical Prattle for 08-12-2002
	Quote of the day: I wanted you to see what real courage is, instead of getting the idea that courage is a man with a gun in his hand. It's when you know you're licked before you begin but you begin anyway and you see it through no matter what. Harper Lee, To Kill a Mockingbird, 1960

Good day! Courage pilgrim.....there are many stories in the Prattle this week that could make you weak in the knees but solutions are also offered. I saw Courage the week before my Boundary Waters trip....in soccer. The North Suburban Sosser Association Boys U14 Premier club had lost an inportant game the week before that will religate them to a lower level of competition next year...just before the Minnesta State Championship tournament. One boy would be moving to California after the tournament and likely not see the fellows he played with for 4 years again...ever. The boys know that teams that are "demoted" fall apart as some players are gobbled up by other survivors. This is where the courage come in....to make a long story a little shorter....the boys WON the MINNESOTA STate Championship and will represent Minnesota in advanced play next Spring...hopefully Regionals and Nationals.

I'll include a picture of the team at the end. For now, take some energy from this and apply it to your day today...things might look bleak but you may just find that little extra in you to win...and win BIG! (ps My son in the one in the lower right corner). Now for some Prattle....

1) Rescue inhalers indicate major problems for asthmatics

SIXTEEN TIMES the mortality rate if 7 to 12 rescue inhalers were used in the previous year. If more than 13 inhalers were used the mortality rate was FIFTY times. Asthma is an inflammatory disease, not a lung disease. If patients are using rescue inhalers regularly it indicates the need for maintenance, anti-inflamatory therapy. Many PBMs have programs to promote the rational treatment of asthma and avoid emergency room visits and mortality. http://story.news.yahoo.com/news?tmpl=story2

2) I'm all TAPped out….
	This is an interesting insight into the illegal activity related to drug promotion by TAP Pharmaceuticals. This is a primer on what NOT to do if you want to stay out of trouble. http://www.boston.com/dailyglobe2/215/metro/US_probes_drug_firm_incentive_at_Lahey+.shtml

3) Not just in clinics….hospitals attempt to limit pharmaceutical representative influence Hospitals are now starting to limit access to there physicians by pharmaceutical company representatives....will patients suffer as they are deprived of free samples or there physicians are deprived of exposure to drug informations (even if it is biased...the doctors get to know the names of drugs through repeated exposure....and most don't have time to watch all of the Direct to Consumer ads on TV). http://www.boston.com/dailyglobe2/213/business/Mass_General_moves_to_curb_drug_vendors+.shtml

4) The cost of sneezing just went dow!

A judge ruled that other companies can make generic Claritin when the patent expires. This could mean a lower drug spend for all, just because of generic competition. For the most adventuresome of you, it might be a good idea to block all non-sedating antihistamines from your pharmacy benefit. If members want the drug then they can get it over the counter. Look for member to ask physicians to be switched to Clarinex or other prescription products so that the employers have to pay. (Sure there will be noise….either member screams or the CFO's about your budget) http://online.wsj.com/article/0,,SB1028832783118577960.djm,00.html

5) Old and depressed?…you'll stay sicker longer. You can't get younger so the only way out is to adequately treat depression. Many seniors find retirement transition a particularly trying time. Many start to drink which can make depression worse. Psychic pain is every bit as excruciating as physical pain and people can not "snap out of it" or "be strong" or other such clichés... you can not will you way out of depression any more than you can will your way out of arthritis or heart disease. We have safe and effective medications for depression and they should be made available. http://www.reuters.com/news_article.jhtml;jsessionid=GBHQZTGQ0ILEOCRBAEZSFFAKEEATIIWD?type=healthnews

6) So who wants fat bones?
	Bone thinning caused by Depo-Provera in the young and the restless. Eighteen to 30 year olds can show an 18% bone loss. What price artificial sterility?--------------- http://story.news.yahoo.com/news?tmpl=story2

7) Go in Peace…and be healed…but we'd really like to see you every week Diabetics who attend religious services once a year had better levels of C-reactive Protein (CRP). CRP is responsible for heart problems. The link might be weak but it might take some of that COURAGE that we began with to find out for yourselves. (It couldn't hurt!) http://www.reuters.com/news_article.jhtml?type=healthnews

Have a GREAT week... Steve
	Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To be added to or removed from the distribution list please e-mail your request to ppp@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded).