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Pepin's Pharmaceutical Prattle for 01-12-2009

 Quote of the day: Computers are useless. They can only give you answers.

                              Pablo Picasso (1881 - 1973)



Good Morning!


     This week I had to turn off my Blackberry. More accurately, I had to change the ringer to phone calls only. Why? Imagine receiving the title message, RIM_bca28a80-e9c0-11d1-87fe-00600811c6a2, every 3min to 5min. The text of the message on both the Blackberry and email account instructed me not to delete the message in either place.  It seems that my email account and Blackberry were sharing information with each other and I should but out!

      Pharmacist may know a lot about drugs and are responsible for their safe use but they can’t know everything. I was editor of the drug interaction databases at Medispan for much of the ‘90s. It took the entire drug product database, about 86,000 items, and ran it against the drug interactions in the database. The result was over 5 million drug-drug interactions. I don’t care how good a pharmacist’s memory is, there is little chance that all of these interactions could be memorized.  As each new drug is released the number goes up even higher.

     Computer technology is in place as an aid to pharmacist in catching these potentially harmful drug interactions. The problem that exists is that there are so many drug interaction alerts presented to pharmacists that they begin to ignore them. They become just like the RIM_bca28a80 messages I was receiving on my phone. There are some tools to reduce the onslaught of interactions against pharmacists’ eyeballs and psyche. Most computerized medical record and prescription software systems have filters that hide all but the most serious warnings. If pharmacists are finding that they ignore most of these warning then they should consider setting the filters so that they see ONLY the most egregious pairs. Pharmacists may miss the Tums/tetracycline interaction but would see, AND DO SOMETHING ABOUT serious and potentially life threatening interactions.

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was I am excited to tell you that today marks my own person best for days alive in a row!” (DeeDee the nurse who added “Will this get me in the Prattle this week?”

pps. Please note that some of the links may not be up for very long and that

     you should capture or print anything that you may wish to keep.



1) Times are tough when Walgreens cuts workforce.

Don’t worry… they are ONLY management positions. Walgreens would not think about cutting pharmacists (still a shortage) or the number of stores. Sounds like the slowdown may be an excuse to trim some fat buildup.


2) Another one of those pesky studies…

Antipsychotics are once again  shown to increase the risk of death in patients with Alzheimer’s disease. This study was done in London, England. Although I don’t have a great amount of faith in initial reports published in The Lancet, this one reaffirms earlier study results.


3) It’s back…

Previously GSK voluntarily withdrew this new drug for restless leg syndrome but resubmitted Solzira. A new salt form of gabapentin, gabapentin enacarbil, will be marketed if the FDA approves it. Won’t be a blockbuster if approved.


4) Not even in office yet and FDA staffers cry to daddy

Staffers at the FDA are crying foul to the transition team against medical device manufacturers saying that scientific debate was squelched. In the past such excessively prolonged debates about minutia have caused delays in drug and device approval. At some point the debate has to end, a decision rendered and products approved or denied. (just my opinion, I could be wrong).;_ylt=AnMG29SFLK6QKoCS1TOJ9W5Z24cA


5) “Loss leaders” hurts CVS’s bottom line.

CVS cut its PBM prescription rates to attract more business at a cost. There bottom line takes a hit but they expect to make it up over the next 2 years. Expect a reduction in PBM rates to trickle to the other major PBMs as they compete. You can also expect SERVICES to take a hit as well.


6) Financial gurus predict a good 2009 for pharmaceutical stock

Strategists think that expiring patents have already been figured into the price pharma stocks. They could right but I’m still uncertain how the unfettered Congress will treat them.


7) CDC says Tamiflu useless against recent influenza strains

All strains since 1999 have proven resistant. Best protection is, and will be for the foreseeable future, is to be vaccinated. It is not too late for this season.







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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 and supervision of your 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 . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2009 PHARMWORKS,LLC all rights reserved.

Copyright 1998-2009 PHARMWORKS, LLC all rights reserved