ppp 10-30-06

Quote of the day: A timid person is frightened before a danger,

a coward during the time,

and a courageous person afterward.

Jean Paul Richter (1763 - 1825)

What are you afraid of? (I have no fear of dangling a participle!) Stephen King wrote about the various forms of fear… about what frightens us… and has capitalized upon each in different books. It may be a powerful force that bears no reasoning (Bears, alligators, spiders, cancer). It may be the cruel intellect that plots harm (murder, rape, IRS). It may just be the unknown (the dark alley, death, pi). Potential humiliation (speaking in public) or loss of self-esteem, job, fortune, family, or friends can paralyze us with fear. We all face fear; real and imminent or distant and amorphous. How we face these fears will tell much about our past as well as determine out future. We can run away from fear or stand and combat it. Physiologically it is know as the "fight or flight" reaction. In any case we do get a surge of adrenalin (the brand name for epinephrine) giving us a burst of speed for flight or energy for the fight. Some people really like scary movies because they like the rush from the epinephrine released in response to the visual and auditory stimulation.

Memory is enhanced by epinephrine. One example is knowing exactly where you were and what you were doing in September 11th, 2001. The burst of epinephrine forever burned the images into your memory. Soldiers in battle, victims of rape or other crimes may experience the lingering effects of the fear and trauma experienced and have vivid flashbacks to the events. To some it is so real that they experience it all over again. This post traumatic stress disorder (PTSD) traps them into repeatedly replaying the trauma, as if it were a short film clip, over and over and over again. Fortunately, medical science has some chemical tools to combat PTSD in the from of anti-convulsant drugs which "short circuit" the repeated re-viewing of the traumatic events.

Those with PTSD often need some added help, chemical as well as support, to deal with their fears and resume a "normal" life, complete with normal fears. Encourage those experiencing fear that confines them. Years ago it was felt that such people were weak willed. Anyone who is depressed or struggling with PTSD certainly WANTS to be better and do not enjoy feeling the way they do. The old thinking was flawed from the start. Today we know about neurotransmitters, their imbalance and how to manipulate them for the betterment of the patients. No one would accuse a diabetic of being weak-willed in not being able to control their blood glucose… they would suggest seeing a doctor for chemical help (insulin or oral antidiabetic drugs). Support these people in there struggles and refer them to professionals who can help them. Don't be afraid to help!

ps. Best answer this week to the question "How are you?" was "Twice that!" janitor's response to my "SUPERFANTASTIC"

pps. This marks the end of my eighth year of weekly publication of Pepin's Pharmaceutical Prattle (scary!) and the 40th anniversary of my first date with my wife on Halloween, 1966.

New nasal steroid Omnaris (ciclesonide) for allergies approved. Nares are another term for nostrils

Twenty-seven year old man was admitted to the hospital coughing up blood. Careful history revealed the vampire connection.

Tyzeka (telbivudine) was approved to control chronic infections with the hepatitis B virus and limit the liver damage produced. Hepatitis B is transmitted by blood contact or sexually. May limit the transmission to others trough sexual relations but sharing contaminated needles is still asking for trouble.

A study of desmoteplase, a synthesized form of the anticoagulant found in vampire bat spit,

in stroke patients was halted. Watch this one because it could rise again after the preliminary data is disected.

While not in every state, Meijer food store chain with embedded pharmacies, will provide free generic antibiotics to patients with valid prescriptions.

No card needed. I am not sure of the economics of this but with 94% of their patients under some for of insurance they may make out ok.

6) Pfizer's potential HDL raising drug, torcetrapib, may be delayed to 2011.

Not great news for Prizer who has seen pressure on Lipitor sales with the release of generic versions of some of its rivals.

Few people know that leprosy is still alive and well in the USA. It hugs the coastline from New York through the Gulf of Mexico. The systemic animal model is the armadillo and the organism will grow in mouse foot pad. It like cooler tissues which is why it usually follows nerves (destroying them along the way). Immune compromised and mal nourished patients are the most likely to be infected. Not a big surprise that leprosy (Hansen's disease) is now associated with AIDS in Africa but the shock was the "activation" of "hidden" cases of leprosy when patients started taking anti-retrovirals.

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 1998-2006 PHARMWORKS, LLC all rights reserved.

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