ppp 10-05-09

Quote of the day:

If we had no winter,

the spring would not be so pleasant:

if we did not sometimes taste of adversity,

prosperity would not be so welcome.

Anne Bradstreet (1612 - 1672)

'Meditations Divine and Moral,' 1655

I know it is autumn but I had spring on my mind this weekend. Shortly after leaving the house Thursday I received a call from my wife who was stuck in the garage. Every time she tried to open the door it would move, buzz and stop. Fortunately she was able to find a friend to pick her up on short notice. When I finally returned home it took but a glance to diagnose the problem; one of the two springs on the torsion bar had snapped in half. The electronic garage door opener did not have enough “oomph” to make up for the weight difference so the safety mechanism kicked in. Garage door openers have two safety mechanisms: one prevents crushing injury on the way down using a pressure sensor and the other prevents hanging potential with a load sensor.

Health systems have similar safety systems to diagnose potentially fatal problems. By investigating all reports of medication variances (wrong drug, wrong patient, wrong dose, wrong time, missed doses, etc) institutions seek to change their systems to make drug therapy safer. Patterns can be discovered and systems fixed if enough data is collected. If all departments, including nursing, know that the data collection is not to be punitive then everyone is more likely to report problems including “near misses”. The other safety switch is continued monitoring of adverse drug reactions. There may not be enough ADR reports at any one institution to recognize significant new adverse reactions. Reporting of ADRs by all pharmacists, physicians and allied health professional through the FDA’s MEDWATCH system is likely to protect future patients. These systems are not cheap or easy but well worth the effort.

The diagnosis of the broken spring was the easy part. Fixing the problem took time and expense but the result was satisfying and will continue to be as the weather will soon turn nasty here in Minnesota. Now that I think of it, this may be the time to do some preventative maintenance on the snow blower.

ps. Best answer this week to the question "How are you?" was "I am blessed."

pps. Please note that some of the links may not be up for very long and that

Consumer group sues Bayer over health claims for zinc. I do not believe that the plaintiff will be victorious. Their reasoning? “Zinc can be toxic.” Too much water can be toxic; too much salt isn't good; too much oxygen can cause all sorts of health problems; too much of a good thing… priceless!

When it pertains to heparin! After Heparin shipped after October 8^th will use the new USP definition of a unit of heparin. The USP changed how it measures Heparin units so the NEW HEPARIN will be about 10% less potent. I don’t expect prescribed doses to change from 5,000 units to 5,500 units as the standard subcutaneous dose but I’m sure that this will be discussed at all P&T meetings in October.

Drug company exec made a fraudulent press release in 2002 claiming that Actimmune fights idiopathic pulmonary fibrosis and will see up to 20 years in jail after his 2009 conviction.

Novartis compound FTY720, fingolimod, would be a breakthrough oral drug against multiple sclerosis if approved by the FDA. Merck’s oral MS drug, KGaA, might be approved first but this could be out on their heels; as soon as April of 2010 if the FDA finds it OK. Safety will be the key. I expect it to be pricey but it would be hard to come in MORE expensive than the injectable MS drugs.

Researchers find that there is not enough evidence (there’s that word again) to prove that there is any more suicide risk from Chantix than any other smoking cessation pharmaceutical drug.

Behemoth Walmart says that prescription drugs should be “commoditized”! While the pills might be the same coming out of any pharmacy there is a something that differs from Chinese sleepwear, motor oil, and Japanese televisions. Most people do not need instructions or guidance on how to use consumer products (any guy has the instructions for use of a remote control encoded into his “Y” chromosomes.) Most retail merchandize does not adversely interact with other items in the store (unless you count fashion faux pas that defines Walmart “fashion” such as pink Krocs with an orange tank top) Patients need the less quantifiable intervention of a pharmacist to review drug-drug, drug disease interactions and provide patient education on the safe use of medications.

Vitamin D, the sunshine vitamin, supplements in people over 65 may reduce the number of falls. The body makes vitamin D when exposed to sunlight. As people have increased their use of sunscreens the naturally occurring levels of vitamin D have decreased. In the study cited, seniors who took more than 700 international units of vitamin D had significantly fewer falls. Fewer falls mean fewer broken bones. Fewer broken bones mean fewer nursing home stays. For as cheap as the vitamin is, it seems like a wonderful investment.

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