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Pepin's Pharmaceutical Prattle for 06-01-2009

 Quote of the day:

Music with dinner is an insult both to the cook and the violinist.

           G. K. Chesterton (1874 - 1936)

Good Morning!

Free Rhubarb

 As a new PharmD graduate I loved to go to pharmacy conventions. Sure there was the chance to learn more about the latest and greatest pharmacokinetic or therapeutic approaches but what kept me returning was the free food. With the metabolism of a 26 year old and a very active lifestyle I did not worry about the calories, carbs or cholesterol. What I ate I burned up. As I have “matured” I find that there is no such thing as free food anymore. Sure I could find the same food at no monetary cost but THAT is just the down payment. After consuming the “free” food I would be obligated to increase my activity rate to match the excess calories, balance the bad carbs with some good for about a month, and eat fat free food for the rest of my natural life. So far I haven’t had to spend money on exercise equipment (which I likely wouldn’t use more than 3 times) or a gymnasium membership (which I would always find inconvenient). I academically understand this concept now ; it is putting it into practice that is hard.

          Last weekend I celebrated my grandson’s first birthday at my son’s house. He has many rhubarb plants in his backyard and I noticed that some were going to seed. I offered to clean it up for him. He told me that I could have all of the rhubarb that I wanted. I picked all that was ready and shared with two other households in need of free rhubarb. I found out that the rhubarb was not free after all. My bride and I spent 2 hours cleaning and chopping the batch. She spent another 8 hours making rhubarb cake, rhubarb bread, rhubarb jam and rhubarb sauce. We used about a bag of sugar and plenty of other ingredients (all not free). Now we have high calorie treats that fall into the free food category above. If I eat it, and I do LOVE rhubarb, I will have to pay the caloric price.

          Consumers are no better off when it comes to the “free money” of the economic stimulus. The government (we taxpayers) has to borrow money in order to give everyone “their share” of the stimulus money. This adds to the deficit and to the national debt. This would be great if productivity would be stimulated but the money is like those empty calories that leave us hungry for more; they just add to our debt waistline. Better that the government learn to watch its “waste” line and tighten its belt. We, and our children, and grandchildren just can’t afford this “free rhubard” which we are being handed.

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was from my daughter.

She wrote: I was just greeted with “How are you this morning?!”

                To which I replied, “Just peachy, thanks!  And you?”

                “Well, I’m peaches AND cream”


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) The active ingredient in Cialis approved for once a day use in pulmonary hypertension.

The active ingredient in Viagra was approved quite awhile ago. You knew that the longer acting ED competitor would be right behind them. I’m sure that the delay was because they had to do the studies. They also took a page out of the Pfizer book and tested a strength unavailable for ED. Many places use 25mg Viagra instead of Revatio 20mg due to cost differentials. I expect institutions to use two 20mg Cialis tabs instead of two 20mg Adcirca tabs depending on which is less expensive. (for highlights of the package insert)


2) SPARCL? That’s Greek to me!

New study done at the University of Ioannina, Greece found that “Statins” indeed lower the risk of a second stroke in patients who, amazingly, had a stroke previously. It is nice to see that this study backs up the findings of the larger international study. (You do remember the difference between, Ionian, Corithian, and Doric columns don’t you?)


3) Justice Department goes after Wyeth

Medicaide programs purported to have been “over charged” millions for Protonix because the company sold to some hospitals for less. Because they make the rules they say that the government is to get the best deal. Damages are one thing but look to the administration to claim penalties of 3 times that amount. Will help to stimulate the non-wyeth portions of the economy.



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4) An ASA a Day keeps…

A daily baby aspirin for primary prevention of heart attacks, strokes and deaths reduced THAT incidence by 12% but increased major bleeding into the GI tract or head from 0.07% to 0.10%. Article goes on to say that reducing weight and stopping smoking will outweigh any ASA benefits (and without any side effects).


5) Coal tar still works against psoriasis

The 5% coal tar ointment preparation is cheap, and beat the high priced prescription drugs, Tazorac and Avage, against stable plaque psoriasis. The study was small but still offers good evidence. I’m sure lawmakers won’t mind if patients smell like the Le BreaTar pits as long as they can save government healthcare dollars.


6) FDA speaks on DTC ads

 Guidance by the FDA to PHARMA on how to appropriately market prescription drugs directly to consumers would have music and images cut. I guess that catchy tune “Viva Viagra” was making people ignore the warnings. But then again hearing loss and decrease visual acuity ARE side effects of Viagra.


7) Xeloda: CSI nightmare?

Cancer drug produces Hand-Foot Syndrome which makes fingerprints disappear over time. (not to be confused with Foot in Mouth Syndrome from which I chronically suffer). An Indonesian man without finger prints was detained by customs last December. A previous case was published about a flight attendant who lost her fingerprints in 2007.






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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