ppp 04-30-07

Quote of the day: The greatest mistake you can make in life is to be continually fearing you will make one.

Elbert Hubbard (1856 - 1915)

My daughter sent an e-mail to me last week asking if bleach can burn. She had been working with straight bleach in making a t-shirt to wear to a Maverick's NBA playoff game). After I received her response (Her thumb was white and she had no sensation in the end) I gave her a few "first aid" tips and a mini-lecture on the safe use of chemicals. I suggested that she rinse her finger multiple times during the day but I was in a hurry and sent the reply without proof reading it. About an hour later she said that "rising" her thumb over her head in a "thumbs up" position did not help at all. (I had omitted the "n" from "rinse". ) We had a good laugh when I realized my mistake and heard about the response of her co-workers; who all thought they were doing a great job.

One letter or minor detail can affect meaning so proofing material is important. Directions for medications are equally important. One patient complained about the tin foil that was getting stuck in her teeth when she took her Anusol HC suppositories… the frequency was spelled out on the label by the other pharmacist but not the route. My own father had a bleeding problem because he was taking his medications exactly as prescribed: Warfarin 5mg daily and his "other" prescription for Coumadin 5mg every morning. (He did not understand that the refill contained the same medication… by a different name.)

Clear communication is essential to the proper use of medications. Take the "extra" time to explain things to patients, nurses, physicians, and other pharmacists. That little extra effort in "proofing" your own work could be the difference between ineffective or dangerous use and effective pharmacotherapy.

ps. Best answer this week to the question "How are you?" was "Older!" someone an the anniversary of their birth. (like we all don't get a day older every day)

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

Thirteen generic versions of Ambien were approved by the FDA. Looks like the prices will fall right away due to intense competition. The controlled release product will remain as brand name only. http://www.fda.gov/bbs/topics/NEWS/2007/NEW01616.html

Nearly one quarter of the medicare part-d beneficiaries that fell into it could have avoided the doughnut hole if they had used less expensive, generic drugs.

NEJM published a report showing the extent of free food (83%), sports tickets, and samples(78%) given to physicians by pharmaceutical companies. While some may be considered out of line, it seems on the surface that samples benefit only the patient and not the physician. The drug companies benefit from sampling as brand name drugs are used instead of generics.

FDA is launching drug safety reports via pod casts. These are in addition to the traditional print versions. The two available to date are on Zelnorm and pergolide. I'm impressed that the FDA is embracing the new technology.

Pete Rose was banned from baseball for his sports betting. Pharmacia has been permanently banned from federal health care programs for offering over $12 millon in kickbacks to a PBM for better formulary placement of their products. They were also fined another $19 million. Parent company, Pfizer can not be too pleased with the errant child. http://www.reuters.com/article/health-SP/idUSN2534048320070426

Cases of grapes were sold during PROHIBITION with explicit instructions on how NOT to make wine/spirits. Of course all people had to do was extract the word NOT from each instruction. Amigen exec's husband was told NOT to buy stock (no explaination given) in a company which Amgen was about to purchase …. like a typical husband… he went ahead…. He is now being pursued for insider trading.

These are NOT the 3 new genes associated with type II diabetes. Besides the genetic predisposition, sufferers also need exposure to triggering events (obesity, lack of exercise). Sort of like having the genetic predisposition to alcoholism. If you are never exposed to alcohol you will not manifest the disease.

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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