ppp 06-25-07

Quote of the day: For one human being to love another;

that is perhaps the most difficult of all our tasks,

the ultimate, the last test and proof,

the work for which all other work is but preparation.

Rainer Maria Rilke (1875 - 1926)

Little did I know that I would create such a stir. My daughter was rattled, my eldest boy "was going crazy" and youngest was worried. My intention was to give each of them an idea about how much I loved them, It was the evening before some elective surgery that I sent each an email with the title "Just a note". I told each of the how proud I was of them., I mentioned a few accomplishments and some family moments, some serious and some silly, that trigger happy memories. I had sent each of them similar notes of encouragement in the past but the trigger for me was the surgery. I was not trying to upset anyone, just let them know how I feel about them.

General anesthesia once carried a 1% mortality, regardless of the procedure. Today it about 10 times safer due to the newer anesthetic drugs. I weighed the risk vs benefit of sending those mini love letters. The physical risk of surgery to myself was very small but I could not take even the smallest chance that the last thing that they heard from me was a request to take out the trash, mow the lawn, or some drivel about the Twins. It was, and is, important to me that those around me know how much they mean to me and that they are loved and respected.

This note today is of a similar nature and is directed to all of you who have read the "Prattle" for almost 8 years now. I am encouraged by the little notes I receive back from you that let me know that my weekly efforts are not for naught. I am sure that I know everyone who gets the weekly email reminder to check for the latest "PPP" and that we have shared one or more pharmaceutical experiences over the years. I care for you all in a multitude of ways but all very much.

Can you remember the last thing that a loved one said to you before their demise? ( I hope it wasn't "Hold my beer and watch this!" as a comedian once quipped). My dad's last words to me were "I love you." I remember this because it was how he ended every conversation the last 2 years of his life. How would you like to be remembered? Do not wait for a "life event" to let those around you know how you feel… seize the day,,. seize the life… seize the love.

ps. Best answer this week to the question "How are you?" was "Super dooper with a cherry on top!"

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

Letairis (ambrisentan) is a new orphan drug approved for the treatment of pulmonary arterial hypertension> This disease pervious had little or no response to drugs until Viagra was tried and worked. This new addition may be more specific. Side effect profile is similar to Viagra but no mention of and other pharmacologic effects that could put it in competition. One warning: it may produce birth defects so the usual warnings about the use in women with childbearing potential should be heeded.

Lyrica (pregabalin) now approved for treating of fibromyalgia which is a disorder associated with fatigue, stiffness, sleep problems and muscle pain. No other drug specifically indicted for fibromyalgia up until now. It will be interesting to see how the drug fares for this indication after 1 year.

Navigation of the {art D medicare benefit is tough but can be dome with the tools available through CMS. Many plans with multiple formularies make the decision more complicated. This is the cost of competition and the government, if not the seniors, should appreciate the savings.

Although we have had about 13 days above 90 degrees already this summer this news will be good when the weather starts to turn cold in December. A drug used against heart attcks, tissue plasminogen activator (TPA), has been successful in treating frostbite that previously would have caused amputation of the fingers or toes. Although this might not be FDA approved, will it be tried in Colorado and Minnesota? You becca'

Exforge combines Novartis's Diovan (valsartan) and Pfizer's Norvasc (amlodipine besylate) into a single tablet. In Europe 9 out of 10 patients reached their blood pressure goals with the combination. Will be interesting to see how PBM's and employers approach this one compared to Diovan (exclusivity to 2012) and the generic version of Norvasc (patent expired 7/31/06) separately.

A large study of the effect of tamoxifen vs raloxifen in prevention of breast cancer was canceled due to scientific design and budgetary constraints. While I am not, by nature, a conspiracy theory sort of guy….the completion of such a study would answer the question about which drug, if either, provides the best protection against breast cancer. With this know, it would be extremely difficult for the government, who pays for a considerable percentage of all prescriptions, to withhold payment for these drugs.

The next time you sit around a campfire with a bunch of Girl Scouts you may wish to see if the crunch in your Smore is just the usual twig or something more pharmaceutical. Girl Scouts and other community groups may soon be coming door-to-door selling J&J products such as Tylenol, BenGay, Motrin and Sudafed. They would retain 8% of the sales price. Seems a little "out there" for be seeing that Sudfed can ve diverted into the manufacture of crystal meth and that Tylenol is the most frequent source of poisoning.

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 1998-2007 PHARMWORKS, LLC all rights reserved.

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