ppp 07-09-07

Quote of the day: We are more ready to try the untried when what we do is inconsequential.

Hence the fact that many inventions had their birth as toys.

Eric Hoffer (1902 - 1983)

On a Roll Has it ever occurred to you that there are two ways to load toilet paper rolls onto holders? One way exposes the end of the paper to the user such that the paper comes over the top. The second way is to have the paper drop behind the roll so that the paper from beneath. Which one is correct? Most hotels will use technique #1 and the house keepers add the finishing touch by folding one or two edges under to form a nice crisp point that looks sharp and makes it easy for the operator to find the end of the paper. Could this be the "gold standard"? On America's Funniest Videos I watched as a dog pawed down on the paper roll in a running motion until all of the paper was off of the roll. If the dog owner used technique #2 the problem would be eliminated. A different approach to a unique problem.

When conventional approaches to problems (which have worked in the past) fail to work it may be time to rethink our "gold Standard". Drug companies have been traditionally been trying to enhance their drug pipeline with new chemical entities, In the past this was profitable. Recent developments have seen either slower FDA approvas or the uncovering of a new side effect that causes some new drugs to be recalled (with subsequent litigation.) Don't be surprised to see older drug, whose side effect profiles are very well known, be remarketed in combination products. Some may just offer an improvement but each would appear to limit liability and extend drug franchise life.

Society has greatly benefited from the advances in the pharmaceutical industry but the world is already seeing a slowdown in the marketing of new chemical entities. While the repackaging of old drugs may work in the short term the real answers may be in tort reform. Tort reform would limit liability and allow both the industry and the FDA to loosen the restraints now in place and give patient hope from advances on drug therapy. Lawyers won't like it…. but I'm not all that fond of ambulance chasers either. (Was that out loud?)

ps. Best answer this week to the question "How are you?" was "I'm doing fine now that I know you are OK" (a compasionate custodian)

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

Walgreen wants to buy Option Care, purveyor of infusion therapy services. Appears that Walgreen wants to sell more than prescription and OTC drugs, Sudoku books, alarm clocks, photographs…..

Brides-to-be can set up a Brial Registry at stores ranging from Target to Home Depot. The push is to have physicians to enter a mandatory reverse registry of ANYTHING that they receive from pharmaceutical companies. (Minnesota and Vermont require registration already) This Senate initiative would include continuing Education (CME). I wonder if all of the Senators keep track of EVERYTHING that they receive from lobbyists (food, junkets, contributions, money)…. just wondering….

District judge says that FDA approval does not shield pharmaceutical companies from state laws. If the judge ruled otherwise many lawyers would have been put out of business. I think that most judgess were once lawyers…

New British study assesses cardiovascular risk like the old Framingham study. The spin is that the Framiningham study OVERESTIMATED the cardio risk. The British system will only pay for statins for those at high risk. By changing the criteria Her Majesty will pay for statins for fewer subjects. Time will tell if the QRISK is validated. I do hope that the QRISK is orrect and that only those in most need of drug help with cholesterol will have to take the drugs.

Citing patient safety seems to be the main in" greed" ient. Then the potential profit motive of doctors is stirred into the mix. Could it be possible that the British Brand name manufactures also have a profit motive…. to keep theirs?I think it is a little late to unscramble the egg. If all the king's horse and all the king's men want to save money on drugs they'll toss out the challenge.

A Chicago hospital is under investigation due to 2 deaths associate with insulin overdoage. Yet to be seen if these were medication errors or intentional, Hope you have good control over insulin in your institution. More cases uncovered in the hospital and local nursing home.

Scientists claim to have erased or lessened the effects of bad memories through the use of an "amnesia drug". The increased geart rate associated with recall of bad memories was not seen in subjects taking the drug. What drug? They used propranolol for 10 days before asking subjects to cecall unpleasant events. Only flaw that I can see in the study is that propranolol is a beta adrenergic blocker that causes the heart to slow (or not speed up) in physically stressful situations. Even if it does work, there will be ethical questions to be answered before wide spread use of the practice.

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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