Notice:  Due to a recent computer crash we have been rebuilding our mailing list files.  If you have not received an e-mail notification to check for the PPP then please send us an e-mail at  and we will put you back in. If you have received the e-mail notification but had previously asked to be removed from the list then we apologize. Send an e-mail (same address) and we will take you off again.


Search this site

ppp- Current issues

Contact Us



Pepin's Pharmaceutical Prattle for 01-19-2009

 Quote of the day: I tend to live in the past because most of my life is there.
                                            Herb Caen

 Good Morning!

Medicine Man

       Aboriginal tribes all had several position in common; a chief that kept order and made decisions and a medicine man. The latter's power came from years of experience with the local flora and fauna. He could remember which leaf or root would help certain ailments. I have never seen the medicine man portrayed as young but always confident and revered.    

Due to recent changes in the susceptibility of some bacteria a group of antibiotics called the aminoglycosides have once again become popular. There are three in particular that are making a resurgence: gentamicin, tobramycin and amikacin. These drugs initially became popular in the 1970ís when pharmacists became involved with pharmacokinetic dosing of the drugs to give effective antimicrobial therapy without the renal toxicity or deafness. Since that time many new antibiotics have been approved that were easier to use. That was one of the problems with the easier-to-use antibiotics, they were so easy that they became overused and bacteria have become resistant to them.

             According to one renown infectious disease pharmacist from CT, today it is difficult to find newly graduated pharmacists who can effective dose the aminoglycosides.  Many can effectively dose and monitor vancomycin but what started out as a corner stone of clinical pharmacy, aminoglycoside dosing, is now a ďlost artĒ for this latest generation of clinical pharmacists. There are many websites that can help with the log linear calculations but no place that teaches pharmacists how to run a service. Iím sure that they are all bright enough to learn how to apply pharmacokinetics to patient care but they may need some mentoring. It may not be a bad idea to keep pharmacists launched in the 70ís around the hospital for more than just their good looks. If you have already lost your medicine man then give me a call... I make house calls.

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was "I am simply wonderful"

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) Savella(TM) (milnacipran HCl) approved for fibromyalgia.

The drug inhibits both serotonin and norepinephrine reuptake; like the combination of two types of antidepressants. That should make both the Forrest and the (Cypress) trees happy.


2) Do you like curry?

FDA to opens office in India on January 15th with 10 staff members. India is the 4th largest exporter of prescription drugs to the USA. Maybe we can get some good spices out of this as well.


3) The best is often the simplest

Antacids are the first choice in stomach acid reduction. The progression along the armamentarium is antacids, H2 blockers, and finally the proton pump inhibitors (PPIs). Many docs, however, are starting with the PPIs. With generics available, the medication costs are not that different but, generally, with higher potency come more side effects.


4) Wynonna Judd speaks for Alli

GSK hires the country warbler to hawk fat busting OTC drug. The lady sings the praises of the FDA and how safe she feels... but she is paid to do it.


5) If we get the banking system of France, why not a Canadian drug price control system?

Big PHarma is pledging support to the Democratic expansion of health care access but warns the administration against price controls on drugs. Donít expect too many changes to the Medicare Part D program because it is pleasing a lot of people... but expect changes all the same.,0,6180367.story


6) Maybe try de-caff?

Three times as many young people are using sleeping pills. College age kids are on the bandwagon as major users of Ambien and Lunesta. The development of lifelong sleeping disorders in these kids is conjectured.


7) This leaves me numbÖ

FDA issues a warning about topical anesthetics. Two young women recently died after using topical anesthetics during laser hair removal. There are at least 5 cautions for those who want to use them.






Welcome| |Contact Us| ||Shopping| |Privacy| |Corey Nahman Link|

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