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Pepin's Pharmaceutical Prattle for 09-28-2009

 Quote of the day:

The goal of all inanimate objects is

  to resist man and ultimately defeat him.

         Russell Baker (1925 - )   


Good Morning!


I forgot to write down the combination to a padlock I use to secure my deer stand to a tree in the woods when hunting so I can hunt multiple days in the same stand without it “growing legs”. I was sure that I kept the little slip of paper that accompanied the lock when purchased but that, too, eluded me. I could have thrown the lock away and bought a new one but turned, instead, to the internet for assistance. A few click and I had the MATER LOCK site up. They no longer will send combinations to their locks out wily nilly. I dutifully printed out the form to send to them via snail mail, made a photocopy of the lock to show that it was not attached to anything, and had to have the whole thing notarized by a Notary Public.

 Before I sent the packet away for my combination (returned to me in the blink of 4 to 6 weeks) I noticed that there was a listing entitled “Master Lock Lost Combinations” and took a flyer at it. The instructions started out saying that the system would work on most locks but that unless I enjoyed a challenge it would be better to throw away the old lock and buy a new one. There are 64 thousand combinations of numbers on a 40 number combination lock which would be expected to take 21 days of mindless trial and error to crack. Not one to shrink from a challenge I began turning the dials and watching for “stop points” as instructed, dutifully recording all numbers. Following their instructions I found 12 stop points. I could eliminate 7 points because they were not whole numbers but positions between whole numbers. Of the 5 remaining numbers I applied their logic test and found the last number of the series. By dividing that number by 4 and writing down the remainder, I now had my “magic number”.  By adding 4 to my “magic number” many times I now had a list of all of the possible “first numbers” of the combination. A similar algorithm produced the possible “second numbers”. I now had whittled 64,000 combinations down to 80. I was able to open the lock after about 40 tries.

 With over 64,000 drugs on the market and many diseases it is amazing that physicians ever get it right!  What works in one patient does not work in all patients just as one combination does not open all locks. Trial and error are replaced by treatment algorrhyhms and evidence based studies. Researchers need to keep studying and publishing. We all need to keep reading and incorporating the findings into our practices. When we find something that works we need to make note of it and write it down… just don’t do it on a small piece of paper that could get lost. Thank goodness for journals and their editors!

Have a GREAT week!



ps. Best answer this week to the question "How are you?" was "I'm just under the top... because when you are at the top everybody is watching you." (a paranoid optimist)

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) Recall of Children’s Tylenol

Bacterial contamination in raw materials. The sullied raw materials never made it to production but the company is being EXTRA cautious. Kids already put enough junk in their mouths!


2) AIDS vaccine shows promise

Tested in 16,000 people in Thailand. There were 31% fewer AIDS infections in the people who took the AIDS vaccine than in those that received placebo. Note that the operative word is “FEWER”. This does not provide immunity. Last time I checked abstinence from sex and IV drug use were still at 100%. Don’t get you hopes up on this one. Will be many years before approved, if ever.


3) Genzyme plant back on line

Shortage of Cerazyme should end by the end of 2010. The drug is used against Gaucher’s disease which is a rare but deadly inborn error of metabolism passed within families.


4) Just say “NO!” to Yas.

Oral contraceptive, Yas (Bristol Meyers), may be responsible for a recent rash of blood clot related morbidity and mortality. All contraceptives carry a generic warning about blood clots but the recently reported cases of pulmonary embolism (blood clot to the lung) lung emboli have some worried.


5) FDA approved new drug to treat T-cell lymphoma

Folotyn (pralatrexate) was approved last Friday for use against peripheral T-cell lymphoma (PTCL).


6) Ixx-Nay on the Exjade?

Patients with myelodysplastic syndrome (MDS) may have higher risks than other patients taking the injectable iron supplement, Exjade. Kidney failure, excessive bleeding and death were more prevalent in the MDS patients who already have enough trouble.


7) No more Tuti-Fruiti fags

FDA moves, with its newly acquired authority over tobacco, to ban cigarettes containing candy or fruit flavorings. Having had control over food since its inception and with the recent epidemic of obesity, maybe they should investigate introducing tobacco flavored sugar and butter,



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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