Pepin's Pharmaceutical Prattle for 03-03-03
	Quote of the day: Without discipline, there's no life at all. Katharine Hepburn (1909 - )

Good morning! Happy FAT TUESDAY.

No, I'm not making fun of the weight you gained since Thanksgiving….FAT TUESDAY (AKA Mardi Gras) is 3/5. It marks the last day before ASH WEDNESDAY and the beginning of Lent. Because LENT is a period of FASTING and prayer an ingenious way of preparing the household was established. All of the fat and sugar in the house was collected and glorious confections were made and consumed. To make the fast easier, no more fat or sugar was purchased until toward Easter time. "…and lead us not into temptation…" was taken seriously. According to custom the party is to stop at the stroke of Midnight. So why was a fast established in the first place? Some would say that if we can make ourselves "give up" good things on a voluntary basis then it will be easier to avoid temptations that are bad for us. In other words, "to be free from, to be free for". It may have just been an early attempt at "Weight Watchers"....

1) AIDS vaccine fails in large trial.

The AIDS virus can mutate within 24 hours to look to the body as a different virus. The reason that influenza vaccines are effective is that the influenza virus may take a year to mutate. Scientists have to look for SOMETHING on the virus that doesn't change. Let's hope that at least ONE scientist can think faster that the virus. (The name would be remembered in the same ilk as Pasteur, Salk, and Sabin). …Click here for full text of story. http://www.nytimes.com/2003/02/24/science/24VACC.html?th

2) Drug for nerve gas approved by the FDA for military personnel
	Pyridostigmine bromide was approved as a pretreatment to Soman gas. (Now that Express Scripts has the DOD mail order, I wonder how many prescriptions they will fill for THIS! ). …Click here for full text of story. http://www.fda.gov/cder/drug/infopage/Pyridostigmine_Bromide/default.htm

3) (Another) new approach to a Medicare drug benefit.
	Stay where you are and you get some help…move to a smaller network and get a better deal… Sound familiar anyone? …Click here for full text of story. http://abcnews.go.com/wire/Politics/reuters20030227_678.html

4) Big deal!

Pfizer-Pharmacia receives tentative EU approval to merge. This will create the world's largest pharmaceutical company. They have to divest themselves of some interests before it can happen but bet on it. (I know a place to put their "leftovers"…any other takers?) Maybe Merck will want to buy some in oder to climb back up to number two…. …Click here for full text of story.http://www.forbes.com/2003/02/27/cx_tm_0227video1.html

5) Viagra to get a run for YOUR money.

Two more drugs for ED are poised for approval. Cialis (tadalafil) was recently approved in Europe (for the French in particular I presume). Levitra (vardenafil) is about ready. Both last longer than Viagra. Both should NOT be used in men taking concomitant nitrates (nitroglycerine). Another drug (apomorphine) may hit early next year that may not have the nitrate contraindication. You may wish to examine your ED quantity limits and adjust them downward and apply them to the new drugs as well. An early adjustment in your Viagra limits is just like a good defensive hockey play…cut the angle early and there is less net exposed. …Click here for full text of story. http://www.healthscout.com/printerFriendly.asp?ap=1&id=511709

6) I can go into the living room again…I'm on the patch!

Patches are not just for sea-sickness, contraception, smoking cessation, or hormone replacement. This new one is used for "over active bladder". Most oral medications do not get refilled due to side effects. The patch seems to have fewer anticholinergic side effects but I suppose its effectiveness DEPENDS on how you apply it. I wonder if they have a veterinary product... not for Veterans...for puppies... …Click here for full text of the company's news release. http://www.watsonpharm.com/watson_html/site/investor/press_det.asp?id=386478

7) Vermont wields a drug formulary as a weapon.

Vermont tries to force Glaxo to sell drugs to illegal Canadian pharmacy operations. What ever happen to the original formulary concept that drugs were placed on the formulary because they worked and were cost effective? I agree with Corey Nahman. on this. Vermont legislators should be ashamed that they are promoting illegal activity while interfering with commerce and proper medication management. …Click here for full text of story. http://story.news.yahoo.com/news?tmpl=story&u=/nm/20030227/hl_nm/vermont_canada_dc_1

Footnote:
	When asked what we should name the (impending) new baby, my then 3 year old daughter said, "Emily". We asked what we should name it if God sent us a boy. Without missing a beat she answered, "Mr. Rogers" . Fred Rogers died this week. He provided a safe and gentle place for us all. Our hope is that he is now enjoying his own safe and gentle place and meeting lots of new neighbors.

Have a GREAT, neighborly week! Steve

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 a supervision of you 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 ppp@pharmworks.com . All insightful comments from readers are thoughtfully considered (the rest are callously discarded). Copyright 2003 PHARMWORKS,LLC all rights reserved.