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Pepin's Pharmaceutical Prattle for 05-04-2009

 Quote of the day:  There is no nonsense so arrant

                          that it cannot be made the creed of the vast majority

                          by adequate governmental action.

                               Bertrand Russell (1872 - 1970)

Good Morning!

This little piggy went to market

         Egypt ordered the slaughter of all swine in the country. Farmers, who raise the pigs for the 10% of the population that is not Muslim, stoned the caravans of government truck trying to carry out that order because they were not to be compensated for the loss of their herds. Pork belly futures have plunged. China has prohibited the importation of pork from Minnesota. Schools have been closed in Texas and commencement ceremonies have been canceled elsewhere. Why the mass hysteria? Friends have had their Mexican vacations canceled. Japan is using thermal detectors at screen people seeking entry into the country looking for fever. Non-healthcare people (read postal workers) are authorized to distribute prescription drugs without a prescription or proper labeling. All of the above are due to fear of the Swine Flu (AKA Influenza H1N1) that originated in Mexico.

One week ago I was on a conference call with the Center for Disease Control (CDC). The speaker initiated the call by saying that anything he said over the next hour would likely not be true 2 hours from the start of the call. While that should have been my clue to terminate my participation I continued to listen. At that time there were 40 known cases. One Catholic Boys school in the Bronx had 20 confirmed cases and 15 unconfirmed. My first thought was to call the Bishop, (All cases have now been Confirmed). I did learn that amantidine and rimantidine do not work against H1N1. The good news is that both Relenza and Tamiflu are effective. The sales of these drugs at the wholesale level has risen more than 700% (wholesalers will not allow the medications to me returned for credit to discourage stockpiling).

As of 6pm on Sunday, 5-3-09, there were 226 confirmed cases and one death of a previously ill child in Texas. You can check the current numbers by state by clicking     The most common symptoms include fever, muscle aches, sore throat, cough, and/or runny nose. If a flight crew notices that any passenger has these symptoms they are to notify the CDC and quarantine will be initiated at the airport upon landing.

Hospitals have been put on alert and are curbing visiting hours, educating visitors and patients about the disease and how to avoid getting it. Just like the Terror Alerts  (Code Orange right now) the WHO has us at DEFCON 5 (out of 6). The CDC has already released 25% of their Strategic National Stockpile (SNS) of Relenza and Tamiflu to the states.

How can you prevent contracting H1N1? Wash your hands with soap and water for 20 seconds or more (That is 2 verses of the Happy Birthday song…time it yourself if you don’t believe me). Avoid touching your nose, eyes, or mouth with unwashed hands (really a good idea any time). The CDC adds Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not to touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.  If you must use a facemask the please cover both your mouth and nose (if your nose is too big to cover with a facemask then you likely have other problems.)

If you have “the flu” or symptoms described above then STAY HOME and do not spread the virus.  Wash your hands as above and cover any coughs or sneezes with a tissue and throw it away. Stay hydrated and use OTC preparations for fever (acetaminophen, aspirin, ibuprofen as appropriate) to keep fevers down.

This “SWINE FLU THING" is WAY out of control. Not the disease but the hype!This influenza is no worse that the run of the mill, yearly influenza that circulates throughout the world. Tens of thousands of deaths are attributed to these yearly outbreaks in the US alone but I haven’t seen this much hysteria since last November. If we so afraid of this virus coming into the country from Mexico they why aren’t we curtailing illegal immigrant crossing with renewed vigor? Maybe the border patrol could use infrared detectors and detain those with a fever…  (Why should Japan have all the fun?)

I hope that the CDC learns several lessons from this: 1) name the virus by number rather than associating it with an animal (especially one we export) 2) Don’t cry “WOLF!” before knowing if the virus is a real health threat (people will be less likely to heed the next warning as this one fizzles. 3) Don’t stat your conference calls by letting everyone know that the information will be useless by the time the conference is over.

The children’s poem played with toes:

This little piggy went to market (but no one would buy him because they were afraid).

This little piggy stayed home (smart piggy if he had H1N1)

This little piggy had roast beef (no ham on the shelves)

This little piggy had none

     (being in the pork business he lost his job and income when international contracts were canceled)

And the last little piggy is the CDC, crying WEE WEE WEE all the way home (followed by FDA & WHO)

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was "I'm sick of all the Swine Flu hype!" ... an infection control health worker


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) EVERYTHING that the FDA wants you to know about H1N1

Not a bad resource. Has a little more about drugs and the EMERGENCY AUTHORIZATION for use of Tamiflu and Rlenza for physicians. This removes restrictions based upon age and use of products beyond their expiration dates to name a few.


2) … and WHO is jumping on the bandwagon

Just as the Mexican and US cases have appeared to have peaked. Expect H1N1 to be part of the standard influenza vaccination for NEXT flu season. Maybe the good that will come out of this is that more people will get the vaccination.


3) Hydroxycut to good to be true?

Yep! Death caused by Hydroxycut use was the trigger for the FDA to demand recall. Many others have experienced liver damage from the product. I wonder what silly commercial will take its place.


4) Chantix reduces heart attacks?

A small study has show promise, Bigger study may be in the works to counteract all of that “crazy talk” about psychiatric side effects. It is already know that smoking cessation, of itself, will reduce risks,


5) 900% more Floridians die of narcotic overdose EVERY DAY than have died in the USA since the H1N1 flu hit.

There are more “Pain Clinics” on some streets than STARBUCKS. Florida will likely initiate legislation to track narcotic use and reign in these senseless deaths.


6) Seniors generally happy about SOMETHING…

Medicare Part D satisfies 80% of recipients. I would bet that most of the other 20% have fallen into one side of the “donut whole” without emerging on the other side.


7) Antibiotic recall

All lots of Robaxy’s nitrofurantoin 100mg capsules are being recall due to being out of laboratory specifications. Recalled products may produce more nausea and vomiting than normally seen with the product.







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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