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Pepin's Pharmaceutical Prattle for 02-22-2010

 Quote of the day:

Labor to keep alive in your breast

that little spark of celestial fire called conscience.

      George Washington






Good Morning!

By George

Past PONTUS (Presidents of the United States) were honored last Monday, Feb 15. When I was growing up we celebrated Lincoln’s birthday on Feb 12th and Washington’s on Feb 22nd. I suppose that there is a certain efficiency gained in lumping them all together but I think a lot is lost. Instead of recalling the virtues, real or imagined (cheery tree legend etc), of these two individuals we throw in Taft, Harding, Polk, Garfield, Arthur, and Hayes to “dilute” the day. Contrary to popular belief each one of our past presidents were not all good. Neither were they all bad. Each brought his own experiences and agenda to the office. Each man had his own set of virtues and vices. What are the qualifications for election to the Presidency? There are three: 1) must be at least 35 old, 2) must have lived in the US for 14 years, and 3) must be a natural-born citizen. Most of you are thus qualified to be PONTUS.

What are the requirements for prescription drugs? They must prove themselves safe and effective. Not all drugs are as important as others. (eg. another NSAID vs another anti-cancer drug). Some Presidents have been greater than others. I wonder what type of candidates would be fielded if they too had a 4th and 5th requirement; to be both safe and effective. 

I will take a minute today to remember the contributions of George Washington to our fledgling government on this the nominal 278th anniversary of his birth. (He was actually born on February 11, 1731 under the old, Julian calendar but his “birthday changed” when a new, Gregorian calendar was adopted by the colonies in 1752. The removal of eleven days were necessary so that the seasons would not drift over time. You can read more about the change at . (By the way… the following was a trick question used against fledgling library student: What day of the week was September 7, 1752 in London?) The correct answer was that there was no such day. And now you know!

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was "I am blessed sir, I am blessed."

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) Monte Hall he WAS!

After making just one too many deals on the healthcare front (with the ‘Bama administration) Billy Tauzin is out on his well heeled ear. While he is “resigning” he certainly fell out of favor with PhRMA members after giving away $80 BILLION. The former member of the House for 26 years (as both a Democrat and later as a Republican) was knocking down $2million per year. This development is expected to further hurt the possibility of healthcare reform passing into law.


2) Nicotine patches at the gas station?

Two anti-smoking groups are urging the relaxation of sales venue requirements for nicotine patches and gum. They want them sold wherever cigarettes are sold. No longer would pharmacies be the only place for nicotine products. Without any support the quit rate is not too impressive so good luck having Gomer or Goober Pyle counseling Joe Packaday on how to quit. And the groups want the FDA to remove all of those scary side effect warnings… as if people shouldn’t be frightened by the warnings on cigarette packages in use since 1984:

SURGEON GENERAL'S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy.

SURGEON GENERAL'S WARNING: Quitting Smoking Now Greatly Reduces Serious Risks to Your Health.

SURGEON GENERAL'S WARNING: Smoking By Pregnant Women May Result in Fetal Injury, Premature Birth, And Low Birth Weight.

SURGEON GENERAL'S WARNING: Cigarette Smoke Contains Carbon Monoxide.


3) Horizant goes horizontal

A long acting form of gabapentin was denied FDA approval due to pancreatic cancer in rats. Makes me wonder if this will have any effect on the EXISTING forms of gabapentin (Neurontin).


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4) Drug diversion? 70 months!

Florida  drug “wholesaler”  sentenced to 70 months in jail for diverting growth hormone. Will be sent to the BIG house.


5) Burst appendix? Avoid 2 drugs or develop an abscessed belly.

Patients with perforated appendicitis should receive neither ranitidine nor diphenhydramine. A four-fold increase in the incidence of intra-abdominal abcess formation was seen in patients give either drug.


6) Metformin stinks

Some patient report that metformin (an antidiabetic drug) smells awful to them (like dirty socks). Others can not smell the drug at all. I have found the same thing with spironolactone but the smell is a more pleasant, minty smell. Something that would be an interesting study would be to see if those who smell these two drugs respond to it differently that those who can not smell it (receptor theory). Might give us a clue in whom to use the drug without wasting the time and exposing patients to side effects. Just so crazy that SOMEONE might actually do the study.,2933,586125,00.html


7) For Pharma geeks… report on drug induced liver disease and skin reactions.

This is the third report from the group. Seems like there may be a genetic basis for these drug induced problems.





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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 1998-2010 PHARMWORKS,LLC all rights reserved.

Copyright 1998-2010 PHARMWORKS, LLC all rights reserved