Pepin’s Pharmaceutical Prattle for 10-20-2003
	Quote of the day: When the habitually even-tempered suddenly fly into a passion, that explosion is apt to be more impressive than the outburst of the most violent amongst us. Margery Allingham, Death of a Ghost, 1934

Good morning! Just back from the Academy of Managed Care Pharmacists meeting in Montreal. I saw many old friends and made a few new ones. These conventions serve a higher purpose than filling hotel rooms and increasing the average cholesterol counts of attendees. This is where we hear of new ways of doing things; of new methods of treatment or health care delivery; of new drugs in the pharmaceutical pipeline and ways to assure their proper use. Besides the real wine and a few real wines this is the heady professional wine that re-energizes the professional lurking beneath the façade of a "burn out." I heard the "burn out" only happens to people who were "on fire" to begin with. The support and new ideas at the meetings kindle the flames and keep the fire burning. Go too long between conventions and you run the risk of burning out. This does not only pertain to pharmacist but to all professionals asked to "o more with less" year in and year out. You may find yourself flying into am explosion of passion that you forgot yourself capable. If you haven't been to a convention in awhile then now is the time to look at the calendar and plan some time away. You will also learn that the "shop" actually CAN function without you and you can move some tasks down the feeding chain. If you can not get away, then at least try to learn something new each day….it will keep you fresh until you can get away.

New to Pepin's Pharmaceutical Prattle and wish to receive a notice when each new edition is available? Simple send an e-mail to …http://www.pharmworks.com/contact.html . You can extend an invitation to other colleagues as well….the more that are on fire the better chances of the profession moving forward faster.

1) Mematine now FDA approved…but I can't remember the indication….
	Oh yeah…..Alzheimer's disease! This is the first one for MODERATE to SEVERE disease.. The drug does not reverse disease but may arrest it. Expect to see more drugs for this…ZI just hope that PHARMA will find one before it need it… (too late you say….bah) …Click here for full text of story. http://www.fda.gov/bbs/topics/NEWS/2003/NEW00961.html

2) Your new 505B plan….
	This new regulation will allow generic manufacturers to "piggyback" on the original research filed with the FDA in order to gain approval. Should speed brand to generic switch which may give you some relief on your drug spend. …Click here for full text of storyhttp://story.news.yahoo.com/news?tmpl=story&u=/dowjones/20031014/bs_dowjones/200310140033000018

3) Counterfeit drugs enter the supply chain easier than box-cutters pass security at the airport.
	If we can't protect ourselves from this mess, just imagine what it would be like with "re-importation" ….. the switches could occur outside the USA and gain the air of legitimacy. …Click here for full text of story. http://www.washingtonpost.com/wp-dyn/articles/A44908-2003Oct18.html

4) Lancet draws a little blood.

The Lancet (a medical journal) touts a study that indicates Procrit/Epogen/Aranesp used for anemia cause failure of caner treatment. Before you get the "PA bug" and try to "protect" your members you should understand that The Lancet is notorious for publishing trials that do not prove true upon further study. They are the "bleeding edge" of medical publications. I am going to bet that this does not prove true. …Click here for full text of story. http://www.reuters.com/newsArticle.jhtml?type=topNews&storyID=3635082

5) Half and Half- for almost $7 million/ year…

When the 100mg and 50mg tablets cost the same…wouldn't you buy half the number of 100mg tablets and take half a pill a day if you needed 50mg per day? That is how Kentucky sees it for their Medicaid population. Not a new concept but It is nice to see that States are catching on…who knows…maybe even a 3 tier benefit some day… …Click here for full text of story. http://www.courier-journal.com/localnews/2003/10/10ky/met-front-pills1010-6189.html

6) October 17th was the deadline for Mediare Drug Benefit legislation…
	We have yet to see October 31st and whether the dead may rise again…This reminds me of the Freddy and Friday the 13th movies….it never seems to be over. If they fail this year it will get even more rancorous next year before the elections.(Just my opinion…I HAVE been worng…. make that wrong). …Click here for full text of story. http://abcnews.go.com/wire/Politics/ap20031014_2030.html

7) 20 fold overdose of Morphine….letter to HEALTH PROFESSIONALS.

Liquid morphine product: MDs confused mg with ml and resulted in deaths. Hopefully pharmacists will catch such problems but in this enlightened time of using higher dosages of narcotic to treat pain the effective and lethal doses may be just too close. (This letter is from June but the FDA just released another similar letter). …Click here for full text of story. http://www.fda.gov/medwatch/SAFETY/2003/roxanol.htm

8) Monkeys can play video games with just their minds.

Amazing as this is it may actually prove useful for quadriplegic patients. While the monkeys were playing the video games a computer was mapping their responses and learning what the brain patterns meant. The joy stick was disconnected and the monkeys played the games using only their brains. While not exactly PHARMACEUTICAL in nature it would be interesting to see if enhancing neurotransmitters in the monkey brains with antidepressants would make it work even better…..(just curious). …Click here for full text of story. http://www.msnbc.com/news/979596.asp?0cl=cR

Have a great week...(I should have survey results next time) Steve

Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARMWORKS, LLC and Steven M. Pepin, Pharm. D, BCPS. The opinions expressed are those of the bald-headed author. To start or stop any drug without the advice a supervision of you physician would be stupid. So don't do anything based upon what you read here without professional advice. To be added to or removed from the distribution list please e-mail your request to spepin@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2003 PHARMWORKS,LLC all rights reserved.