ppp 03-13-06

Quote of the day: Time is the most valuable thing a man can spend.

Theophrastus (372 BC - 287 BC),

from Diogenes Laertius, Lives of Eminent Philosophers

A friend of mine just turned 55 years of age. In a flash-back to an old Sammy Hagar song, he said that now he can "drive 55". This comment "clicked" for me and fed into a common observation that life accelerates with age.

We start creeping along… summers seemed to last F-O-R-E-V-E-R in grade school. The pace was just about right when I was first married. As the children got older (me too) the summers shortened and now the years are flying by. Traveling 55 has been fast enough but I’ll add another MPH in April. I hope to be driving 100 by the time the old vehicle runs out of gas. If I want to be 100 then I have to go through all of the years in between and “so far…so good!”

Speed bumps. We all encounter them. Health problems like diabetes, high blood pressure and stress are a few. We put some obstacles (akin to spike strips used by the police to stop speeding vehicles) in the road ourselves:: smoking, alcohol, obesity. (Don't tell me you have never watched Cops or World's Most Amazing Police Videos!). Stress is another such obstacle that may come from within or from external sources. Desserts is the word "stressed" spelled backward. I will have to watch my weight or I’ll never make freeway speeds.

Poor Kirby Puckett did not have a chance to go above 45 so I’ll continue to be thankful for every day above ground.

ps. Best answer this week to the question "How are you?" was "Alive and feelin' fine""

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

Tysabri, a drug used against multiple sclerosis(MS) until last year due to a rare, life-threatening adverse effect, may soon return to the market. The difference between Tysabri and other drugs used against MS is significant. Patients feel that the added risk outweigh the potential for serious harm. Expect an intense Phase IV follow-up study to accompany any release. May be almost as stringent as the original Clozaril or recent Accutane programs.

I thought I just had to watch out for 20-somthings in Neons or in F-150s! Now we have Ambien implicated in about 10% of all impaired driving arrests. Police report strange behavior including people who drive while "asleep" or "sleep-driving". If you take sedative-hypnotic drugs at night then if would be good to know of any lingering effects before getting behind the wheel. (Just a thought… I could be wrong!).

Combining 2 drugs in one pill has been successful for many drugs but Merck has had recent trouble formulating its proto-type 3-drug combination pill against cholesterol. While this might save a copay or two, one of the drugs is over-the-counter. Looks more like a marketing strategy to prolong franchise-life than a huge, unmet need. One of the components was added to counteract the facial flushing seen with niacin. (Little know pharmaceutical trick: if you get flush with niacin then take a small dose of aspirin[if you can tolerate it] and the flushing go away immediately)

Acetylsalicylic acid (aka ASA) is still the best at preventing death, heart attack and stroke. Addition of Plavix did not add a significant benefit to patients (measuring these endpoints) in a 28 month study of about 15,000 patients. There I go with that "evidence-stuff" again.

Minnesota is to medical devices what New York, Pennsylvania, and Research Triage Park are to drugs. If a primary, bare-metal stent become blocked then radiation therapy has been used to open it again. These drug-coated cousins may be ore convenient and provide better outcomes.

That's right… attention surplus disorder. Some new ways of looking at a mismatch between intentions and actions. In a world where EVERYTHING is demanding your full and undivided attention, NOTHING gets your attention. No wonder that up to 15% of the population might be considered as having attention deficit disorders. Something to ponder, other than the back-box warning, before starting to take Ritalin. (NYT- free registration required)

Someone at Walgreen typed "Crazy" and "Psycho" into a patient profile and it came out on the patient's printout. She is suing. I once had my Pharmacist's "barber-style" smock pulled up over my head by an angry patient. When it was over I was standing in my under shirt face to face with a "disturbed" man. Warning other pharmacists about the unusual behavior would have been the prudent thing to do. While the terminology in this woman's case was unfortunate, I think it is reasonable to warn others about how to handle "special needs" patients. (your thoughts?)

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 1998-2006 PHARMWORKS, LLC all rights reserved.

--------------------------------------------------------------------------------------------------------------------------------------------------------------------