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Pepin's Pharmaceutical Prattle for 07-06-2009

 Quote of the day: A sound mind in a sound body is a short

                  but full description of a happy state in this world.

                      John Locke (1632 - 1704)   

Good Morning!

Body Parts

We anthropomorphize many things in our lives. Most people think of their automobiles in terms usually reserved for humans and often even give them names and attribute personality traits to them. When a car won’t start we are more than likely going to talk to it. We impugn them with diabolical motives when they don’t work. We lavish gifts upon autos that are more expensive that most items we give to our human loved ones (new tires, fancy wheels, special waxes).

We also attribute different properties, affections and qualities to parts of the human body. The brain is revered for its ability to reason and coordinate the other parts. The heart is attributed emotions such as love although it is just a pump. Having and “eye for art” is considered a good thing but all eyes, save those which are color blind, transmit the same information to the brain. An “ear for music” likewise, although the same vibrations stimulate all ears. Fingers and arms caress and are considered in a positive light and we often will have a “gut feeling” although our intestines have little to do with such perceptions.

          We rally around relatives who have organ problems. Heart problems bring the highest levels of support due to the “love” society has attached to it. Epilepsy and schizophrenia terrify most of us because each represents a loss of control so these “brain control problems are perceived very negatively. Loss of other senses causes loved ones to rally around too as we can empathize, being able to imagine the effects of their loss.

          One important part of the body that hasn’t received much positive or negative attention is the pancreas. The little organ which sits just under our left ribcage area about the middle of the body is very important to our survival but gets no attention. Normally the little fellow produces enzymes that aid in digestion and a very important substance useful in blood sugar regulation: insulin, Lack of blood glucose control (diabetes) is the number one cause for people to loose their kidney function and require dialysis. Diabetes is also a leading cause of blindness. Many with diabetes also develop heart disease and/or stroke,

          It may not be glitzy or showy but FREQUENT diabetic blood monitoring is essential to the control of diabetes. This goes for both type-1 diabetes (which is insulin dependent) and type II diabetes which is often associated with obesity but can be cotrolled with diet, exercise, and oral antidiabetic drugs. The testing is for all diabetics: not just the type-1 diabetics. If you are diabetic or know someone who is diabetic please urge them to test frequently. I’m sure that all diabetics can learn to do frequent blood glucose testing… I can just feel it in my appendix.

Have a GREAT week!

Steve

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ps. Best answer this week to the question "How are you?" was "I'm better than I deserve. I am truely 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.

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1) FDA panel urges ban on Percocet and Vicodin

Because these drugs contain acetaminophen the advisory panel put these opiate/acetaminophen combination products on their hit list, We might be able to get along with the single entity products such as oxycodone and acetaminophen, each given separately, in the stead of the Percocet product, A bigger problems looms for the Vicodin-like products because there is no individual oral hydrocodone product. There is a Vicoprofen product (brand name only) that combines hydrocodone and inbuprofen together that could be used instead assuming: 1) cost is no object and 2) the patient is not allergic to asa or other NSAIDS. I expect cooler heads to prevail but I have been disappointed in the past by FDA “logic”.

http://health.msn.com/medications/articlepage.aspx?cp-documentid=100241255&gt1=31036

 

2) You’d be crazy to smoke…

… and you’ll be crazy if you try to stop smoking (if it involves Chantix or Zyban). FDA is requiring black box warnings on the two major oral smoking cessation products available due to potential to precipitate psychiatric side effects.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm170100.htm

 

3) FDA approves Multaq for arrhythmias

This new drug, dronedarone, is similar to one already on the market. Multaq was approved for use in the USA. I expect this one to break the bank related to drug spend with anticipated annual sales approaching $2 biooin per year in a few years. It won’t be cheap relative to the generic alternative so we will have to see the marketing spin on this one.

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm170276.htm

 

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4) CDC warns of Recreational Water Illness

If you swim at public beaches or pools this summer you may wish to review these warnings. Seems like a little e. coli goes a long way,

http://www.cdc.gov/healthyswimming/

 

5) A statin a day keeps the heart attack and stroke away…

… better than taking an aspirin a day. Overall mortality was reduced by 12 percent, major coronary events by 30 percent and strokes by 19 percent. Study showed that statins should be started 10 years earlier in men than women. Read on for details.

http://www.nlm.nih.gov/medlineplus/news/fullstory_86271.html

 

6) Robbing Peter Cariologist to pay Primary Paul.

Shifting of payments from specialists to primary care physicians is in the Medicare cards. Maybe this could reduce the financial pressures on docs to ultra specialize and stay in primary care.

http://blogs.wsj.com/health/2009/07/02/medicare-may-pay-more-for-primary-care-less-for-procedures/

 

7) MJ + Propofol = ?

If reports that Michael Jackson was using propofol are true then the doctors supplying and using the drug may face criminal charges, Yes… it is THAT potent.

 http://www.tmz.com/2009/07/01/michael-jackson-propofol-lidocaine-overdose-criminal/

 

 

Have a SUPER-FANTASTIC week.

Steve

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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 spepin@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 1998-2009 PHARMWORKS,LLC all rights reserved.

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