ppp 10-15-07

Quote of the day: Maps encourage boldness.

They're like cryptic love letters.

They make anything seem possible.

Mark Jenkins, "To Timbuktu"

A few weeks ago we had the widows open at night. I happened by the kitchen window and smelled a skunk. The next evening the same odor wafted through the window as I began to fear that we had a new neighbor. When I mentioned it to my wife, she told me that it was likely the cleomes. The flowers she had grown from seedling were now over 4 feet tall and in full, glorious bloom. She had selected the plant, not only for its color and size, but also for its propensity to stave off out recent rabbit invasion. It appears that those twitchy bunny noses find these flowers as repugnant as we find Pepe Le Pew.

A few years back I had heard that hyperalementation fluids that were no long good for patients would prove a good fertilizer for plants. It made sense because the TPN solution contained high glucose, amino acids, and multiple vitamins. Not one to waste anything, I watered my office fern with the discarded TPN solution and left on vacation. I returned to find that the staff had been cleaning more frequently than normal. They were looking for the source of the obnoxious smell in the office. When I took the fern off the the high shelf, all was revealed. Not only was it the source of the smell but the dirt was coved in a layer of mold. The plant and the smell were simultaneously eliminated.

Did you ever try to do well only to have things backfire? With a little more knowledge I could have avoided burying my nose in the beautiful blossoms for a big whiff or subjecting the entire staff to 2 weeks of nasal assault. Take that “extra” time to research things before jumping in with both feet (or head first as is the case with several of my quadriplegic patients). While “love” or maps or self confidence may encourage us to go without all of the facts, in most cases a small delay to talk with and experienced person may save you all sorts of grief.

ps. Best answer this week to the question "How are you?" was "No half bad" ...someone who was more than half good.

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

Women who were taking antidepressants were less likely to experience “hot flashes” than women who were not. This may just open another indication for the SSRI’s except that with generics available…. who would fund the study to get the approval?

Trileptal will soon be available generically. Was never a huge “mover” but… save a little here, save a little there….

I received a letter from the makers of Tylenol last Thursday. They are pulling their cough and cold preps that had previously been marketed for use in tots. With the FDA breathing down their necks, other have followed suit.

Men who took a statin for 5 years had a lower incidence of cardiovascular events that the men in the placebo group. Ten years after the initial study these men are still doing better that their control group even though some of the control group went on statins and some of the statin men stopped the drug. Maybe it isn’t whether you give statins but when you give them.

Some patients who received Definity before echocardiography died within 30 minutes. Both Definity and Optison, two drugs used to enhance ultrasound studies of the heart, will receive BLACK BOX warnings.

If patients are going to have invasive ear surgery, they need to be immunized against the common form of meningitis. Two incompletely immunized children died as a result.

Appears that the CMS site used to help seniors and their caregivers select a Medicare Part D plan just got simpler but more powerful. Let’s hope so.

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.

--------------------------------------------------------------------------------------------------------------------------------------------------------------------