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Pepin's Pharmaceutical Prattle for 02-02-2009

 Quote of the day: If you know how to spend less than you get,

                  you have the philosopher's stone.

                       Benjamin Franklin


Good Morning!

Playing Post Office 

Having never been exposed, I was not sure of the rules of the teenage party game called “Post Office” so I looked them up.

  The group playing POST OFFICE is divided into two groups; one male, the other female. One group goes into another space or room, such as a bedroom, which is called "the post office."   To play, each person from the stationary group individually visits "the post office"—once there, they get a kiss from every member in the room.  Once everyone in the first group has taken a turn, the other group begins sending members to the first room.  In this way every member of both groups is guaranteed a kiss from every member of the opposite group.

While this type of activity has sent many a hormone on its merry way it was, in effect, communistic - everyone received the same attention from the same people without regard to the amount of effort or skill. Spin the bottle may have been more random but the “all are treated equally” bias was still there.

Our US Postal Service will soon be playing spin the bottle with mail delivery. It appears that one day of mail delivery will be cut from the schedule. Most bets are for the elimination of Tuesday because it is the lightest day.

Last year $2.8 billion was lost on the delivery of 202 billion items. When I did the math I found a loss of 1.386 cents per item. The next mail rate increase is scheduled for May of 2009 and is expected to be 2 cent in first class postage. This is a lot like school board threats to eliminate sports when they are asking for a mil rate increase for education. In the case of the Post Office it appears that their loss will be covered by a rate increase. In their defense, the Post Office has been trimming other budget items and is becoming more efficient.

When I looked at a few more of the numbers in the article I found that one big drain on the Post Office’s bottom line has to do with the funding of retirement. Almost 4 cents of every item delivered is earmarked for retirement. Retirement in the non-401K sense has been the demise of many companies who did not foresee the rise in health care costs. I know of one steel company whose workers were supporting themselves and funding 7 retirees. Needless to say, they went bankrupt (about 7 years ago) and all of the retirees lost all of the health benefits upon which they relied. Yes, Unions were involved. No they would not budge in their demands.

So who still has an old fashioned retirement anymore? Federal, state, county and municipal workers do. Members of the House and Senate do. Surprisingly enough, many of those working for pharmaceutical companies have been covered as well. There are still large corporations who are forced into retirement plans by their union workers. Some of the strongest have been the United Auto Workers. Well all know what shape the big three US automakers are in now. Granted that some of the highest executives in these companies are more than well paid the big bucks are in benefits and retirement plans. If the auto makers do go bankrupt then the workers are on track to lose retirement benefits and healthcare. The survival of the entire US auto industry (and the jobs of autoworkers) may be dependent upon being allowed to file bankruptcy. I contend that most Americans are not in favor of big cash bailouts for the US auto industry and, if put to a vote, would vote it down. In effect the US car buyers have all been voting on this issue for years as they placed their “votes” by buying foreign cars. To me the recent “bailouts” and “stimulus packages” seem a lot like Spin The Bottle. “Around and around she goes… where it sops… nobody knows! “ 

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was "Ex-cell-laun-te"

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) Tiny bubbles target cancer

A potential new drug delivery mode involving microscopic bubbles appear to target cancer cells preferentially. Treatment is giving excellent results in animal. Technology may also eventually help patients with osteoarthritis. Much more research needs to be done before this could be applied clinically (expect it in about 10 years… if all goes well).


2) Forced back to Brand name drugs

As production problems plague the makers of generic drugs the only source of reliable extended release metolprolol is the originating company. Insurers are balking at payment for the brand name beta blockers even though there, in effect, is no generic available. Some are forcing a therapeutic substitution within the class but not all beta blockers carry the same FDA approved indications. Expect similar cases as more recalls are issued and more plants shut down, even for a little while. (Brand name peanut butter was not affected by the recent recall… do I see a trend here?)


3) Plavix effects thwarted by PPIs?

In a preliminary report the FDA released information that the pro-drug clopidogrel is not as effective at reducing the chances of a blood clot in some patients. Plavix most be converted from its pro-drug state into an active form by enzymes in the body. Some drug interfere with the enzymes and thus could make Plavix less effective. One class that is thought to interfere are the proton pump intibitors. More studies are in the works.


4) Overactive bladder rubbing you the wrong way?

New gel form of oxybutinin (Gelnique) approved for “over active bladder”. When applied to thigh, abdomen, or shoulder the drug is reported to have fewer systemic adverse reactions such as dry mouth and blurred vision than the oral form. Oral forms are not often refilled due to the side effects experienced. The company will know if it has a winner if people start to refill their prescriptions.


5) Patients own stem cells treat MS

Embryonic stem cells not used here so don’t get excited. Stem cells exist in everyone’s bone marrow (unless you are sick). Researchers harvested these bone marrow stem cells from patients with multiple sclerosis(MS), wiped out their bone marrow, and then reintroduced their own stem cells. This is known as a BONE MARROW TRANSPLANT and has been used in many cancers or marrow failures since the 1970’s. What is most exciting about this application is that the symptoms of MS have been reversed, not just arrested as with other therapies for MS.


6) Occupational exposurer is nothing to sneeze at

Nurses exposed to disinfectants are 60 to 70% more likely to develop asthma symptoms. More studies are urged.


7) Wy-Pfi or bust

Now that Pfizer and Wyeth have agreed to merge the bankers have their say. If the deal falls through then Wyeth gets a $4.5 billion penalty payment. And I though that my credit card late fee was big.






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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