ppp 02-18-08

Quote of the day: I would feel more optimistic about a bright future for man

if he spent less time proving that he can outwit Nature and

more time tasting her sweetness and respecting her seniority.
E. B. White (1899 - 1985)

As the population ages the state sees fewer hunting and fishing licenses purchased. While State park facilities have improved greatly over the last 40 years, those in the 19 to 40 year bracket are not taking advantage of the opportunities. Many are afraid to go out into the woods. A few years ago two physicians moved in across the street from us. They were from New York and adamantly refused to venture into the 40 acre nature area adjoining our properties for fear of “wild things”. About the most vicious varmints in the vicinity are the rabbits and deer who violently chew on our variegated hosta and vegetable garden. All of the snakes are non-poisonous and bugs, harmless. (OK the mosquitoes can be pesky.) Because they had only lived in the Big Apple they were afraid on anything green, growing, or non-human.

As fewer people leave the comfort of their homes and Wi-Fi range, the fear is that protecting the environment, parks and lakes will fall on the people’s priority list. To counteract this trend, Minnesota is entertaining the rental of tents and camping equipment and will soon begin to offer classes on how to start a fire (campfire… not arson for fun and profit), outdoor cooking (of something other than SMORES), and pitching tents. The truth is that if children are not exposed to the beauty of nature then they will likely avoid (at best) or fear any area that is not paved or enclosed. If you are one of those who have not embraced nature, then now would be a good time to start. Annual State park stickers (that pay for the upkeep of the park system) are available for less that a fifth of one month of the average cell phone bill or fitness center membership. A yearly fishing license costs less than one slab of salmon at the supermarket. Who knows… you might get some exercise, clear your mind, and eat better with just a little bit of effort. Don’t worry about losing contact with the outside world… with the abundance of cell phone towers your will remain in range. I’m sure that it is less painful to walk into a tree while text messaging that to run off the road. Exposing your children to wild things yourself or through scouting programs will give them full exposure to all of life’s possibilities.

ps. Best answer this week to the question "How are you?" was "Trying not to go broke on Valentine’s day." (a drug salesman over the phone)

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

Sandoz and PriCara (Ortho-McNeil) have recalled fentanyl (aka Duragesic) patches due to leaks. While it may sound like a small defect, the drug is absorbed through the skin and jeopardizes health care workers administering the drug, patients and anyone to whom the patients may become in contact. Death is a possibility as narcotic overdose may occur. This is a consumer level recall.

The FDA never inspected the Chinese (Baxter) plant that produced the heparin that was the subject of a recent recall due to allergic reactions (http://www.fda.gov/bbs/topics/NEWS/2008/NEW01797.html ). Before “mad cow” disease, heparin was extracted from both beef lungs and pork intestines Since heparin is now made for pork intestines alone you don’t think that some other species or contaminants were introduced into the batch when no one was watching do you? As an aside: many people are allergic to equine (horse) products.

Your body produces cortisone, a naturally occurring, feel good steroid involved in many normal physiological functions. Do you know what the precursor chemical to cortisone production in the body? Cholesterol! If you don’t have the building blocks then it is hard to build the internal hormones. Expect to see an increase in depression in any drug that lowers cholesterol, just based on chemistry. Vytorin and Zetia now carry the warning (as if they didn’t have enough to be depressed about with the news of their effectiveness that hit the press a month ago.)

To paraphrase “Drug companies are increasing under attack from Democrats.” From big pharma and DTC ads to the FDA itself, Democrats are poised for even more spiteful assaults on an industry that has traditionally supported Republicans. What Dems don’t seem to understand is that tearing down ANY industry will put more people out of work and many are actually Democrats. Medicare Part D was a bipartisan effort but expect even that to be “revised” in a not-so-pretty fashion.

According to the settlement paid by CVS, it would seem when the PBM makes more money even if the patient copay is reduced and the employers save money. This is a good case for “transparency” in PBM contracts.

Time pressure on pharmacists cited as the main reason for medication errors. “Three things about retail: You can have it fast. You can have it cheap. You can have it right. You only get to pick 2.” Patient’s may wish to use a lower volume store for their prescription needs. Time pressure and workload on nurses and physicians also contribute to errors in those fields.

After Keith Ledger’s death from the combination of MANY different prescription drugs the blame game starts. Instead of the responsible (dead) party owning the blame, he is now being painted as the victim of the medical system. (I guess there isn’t any money in accepting responsibility for one’s own actions). Drug interaction software, pharmacists, physicians can all point to interactions if the prescriptions are all active at the time of a new prescription. A some point the warnings have to expire on old prescriptions. There is no RFID chip that alerts pharmacists that the patient's medicine cabinet still contains pills from when wisdom teeth were extracted 4 years ago. Patients remain responsible for the drugs that they ingest at the time they take them. Sounds like Ledger even tossed in some OTC sleep aids which would not be caught unless entered into his pharmacy profile. If patient’s opt to take news drugs… old drugs… OTC drugs… any drugs... all at once then it is game, set match.

Disclaimer: "Pepin's Pharmaceutical Prattle" (AKA "The Prattle") is the property of PHARMWORKS, LLC and Steven M. Pepin, Pharm. D. 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 1998-2008 PHARMWORKS, LLC all rights reserved.

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