ppp 02-05-07

Quote of the day: Idealism is what precedes experience; cynicism is what follows.

David T. Wolf (1943 - )

I don't know about you but it is cold here in Minnesota. I went ice fishing last Friday and had to drill through over a foot of ice. While 2006 was one of the warmest years on record, 2007 is shaping up as one of the coldest ever. The high for the week will be in the teens with below zero every morning. The St Paul Winter Carnival was going to cancel the final torchlight parade on Saturday until the mayor stepped in to promote a shortened version. Vulcanus Rex, king of fire, does battle with Boreus Rex, king of Winter after the parade. As the legend goes when Vulcanus and his henchmen, the Vulcans, win the battle, the warm weather will soon follow. On Feruary 2nd Punxsutawney Phil did not see his shadow portending and early Spring.

Are there global weather changes happening now? Yes there are. Are they natural or man made, due to the burning of fossil fuels? Although there are "experts" on both sides of the issue I have not seen convincing evidence that links the activity of humans to temperature fluctuations. I see salt residue on the streets and know that all water eventually flows to the sea. The sea is salty but to assume that the salt used on the roads is responsible for the salt in the sea is faulty reasoning. Cause and effect have not been proven. Taking a poll of the population and whether they believe in global warning may sound scientific but it only shows how well proponents have been able to change minds.

In medicine we see many red-herrings. For years tradition, superstition and faulty reasoning have perfused medicine. With the advent of evidence based medicine we can begin to throw off old therapies in favor of things that are true remedies. Are we still doing everything based on evidence?…no, but we are making strides in that direction. We have many legends much like the Vulcanus Rex and Phil stories to overcome regarding medicine. While some things make good headlines or stories, I'll side with the search for truth every time.

ps. Best answer this week to the question "How are you?" was "FANTASMAGORICAL!" My son; quoting from 'Chitty Chitty Bang Bang'

pps. Occasionally, some of the links require FREE registration.... I'm sure you can handle THAT slight inconvenience.

There I go on that evidence stuff agai… Diabetes is better prevented or controlled with diet and exercise than treated with drugs…. go figure.

Center for Disease Control (CDC) has issued a report on emergency measures in case of another influenza pandemic. It involves shutting schools down for 3 months, telecommuting, and "cocooning". The news story ids a quick snapshot of what life will be like if H5N1 (bird flu) or other noxious strain hits. I'm not saying that you have to go out and buy "Back To Basics" or other survival books….just think about it.

Drug makers are looking at smokable forms of drug for truly FAST administration. One drug is prochlorperazine (Compazine), an antipsychotic drug used against nausea but which holds promise for migraine sufferers. The drug is not addicting but could give almost immediate relief due to rapid absorption through the massive surface area of the lungs (equivalent to the surface of a tennis court). A relatively large (handheld) battery operated device would be necessary for the vaporization of the drug…. and just when the bars and restaurants are going "smoke-free".

The vaccine used to prevent Human Papaloma Virus (HPV) infection must be given to every 12 year old girl in order for her to enter school. Some groups are fighting this because they feel that girls will get the message that promiscuity is being enabled. (HPV is a sexually transmitted disease that is associated with cervical cancers in women). What opponents don't understand is that a woman can marry as a virgin and contract HPV from her "not exactly a virgin" husband on her wedding night. I am in favor of this move… Any arguments?

Back when I worked for MGI Pharma I took a call from a brain surgeon who was in the middle of tumor resection, on his speaker phone, asking for information on the implantation of Gliadel Wafers… talk about pressure. MGI has recently received a letter from the FDA on the marketing of the drug impregnated wafer used to line the cavity produced by the removal of brain tumors. I'm sure that the appropriate "ad-justments" will be made. (I no longer own any MGI stock… not even in a charitable trust, a'la Mad Money's Jim Cramer").

What is the FDA thinking about drug safety? This is a huge tome but worth the time. Pharma (including generic houses) would do well to know every tittle and jot. Index is very organized…read what you like.

Viagra and other ED drugs are off of the Medicare Part D plan. Not seen as essential to life and health. Expect a few more items to switch to "Pay to Play" as Part D plans mature.

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 spepin@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2007 PHARMWORKS, LLC all rights reserved.

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