prescription drugs

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To paraphrase some recent political campaigns, the FDA was against Qnexa before they were for it.

I’ve written about this diet drug compound before —  HERE And HERE.

Last time I wrote about this “drug,” I thought it was down for the count. Aauugghh!!!!

Like a scene from “Night Of The Living Diet Drugs” – it is back from the grave.

You bet your life! (Literally if you take this) – our protective government watchdogs at the FDA originally said this was too dangerous to unleash on the public.  Then – as the politicians say – they did a “Flip Flop.” This No-Vowel remedy QNEXA (ok, it has a couple of vowels, but not enough) is not actually a drug — it is a combination of two drugs.

This is of course, the cheapest way to get a new product on the market and eliminate R&D costs as well as testing for safety and efficacy. The company takes two separate FDA-approved agents and combines – kind of like making Frankenstein out of left-over body parts.

(This is turning into a Halloween column, isn’t it?  Sorry.) Read more on They’re Ba-a-a-a-ck!!! Zombie Diet Drugs!!!…

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Many people are proud of the state from which they came. But I value the state they (we, all of us) can go to.

It’s called a “Resource State.”

Don’t bother looking on a map – unless it is a map of the cerebral cortex.  Yet, it isn’t clearly defined as a location in the brain either.

I know it sounds mysterious, but it is easy to access and the benefits once you get there are astronomical.  I think I need to give you some illustrations to make my point.

Once when I was in prison (that always gets attention – but actually I was employed as a prison psychiatrist and not serving time for criminal activities) I treated a young man of 28 who was doing time for armed robbery.  His problem was depression with occasional suicidal ideation. Read more on The Resource State — Your Magic Ticket To Happiness…

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I was trying to remember when prescription drugs were allowed to advertise on television (called “Direct To Consumer Advertising, or DTCA”).  Fortunately, I didn’t have to bust my memory cells – I just had to “Google it.”

1995. The year all HHHHell broke loose.  At least if you were a doctor.

Suddenly, patients could make their own diagnoses and prescriptions and just phone the order in to their doctor.  At least, that’s how most patients thought it should work.  And – hoo boy! – were they upset when it wasn’t quite that easy.

Comedian Dennis Miller has a hilarious line: “I divide medical practitioners into two camps. Those who will give me a scrip for Vicodin over the phone, and those who won’t.”

Hilarious if you aren’t a doctor, that is. Read more on RX Package Insert — Just Read It!…

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If there is one time to get scared, it is when  a drug company, a government agency, a popular magazine article or – heaven forbid – your doctor says a metabolite is “better” than the drug it came from.

A metabolite is the substance that is left after the body breaks down (metabolizes) a medication.
  
Everyone in this picture know that oxycontin — read “morphine” — has lots of addiction-type problems.  Synthesized by the Germans in 1914, it has been around for quite a while, although not terribly commercially exploited until the folks at Endo Pharmaceutical started pushing it. Read more on Pain Killers Can Be A Prescription For Disaster…

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Number 5 in the USA Today catalog of medical changes in the past 25 years is (imagine a drum roll playing – and CYMBAL CRASH!) — antidepressants are the most popular drugs. Read more on Antidepressants Are Popular — And Dangerous…

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Recently, a patient’s widow called to cancel a routine assessment because the patient suddenly died. There had been no freak heart attack and it had not been one of those undiagnosed cancers.  He just “died, suddenly, in his sleep, I guess,” she said. That got me thinking.

The first class of drugs I think about, when I think of sudden death, are the stimulants.  I remember when someone decided that everyone who was going to get stimulants needed to have a “cardiocentric” examination first.  Doctors asked a lot of questions about chest pain, and administered an electrocardiogram.  These precautions were especially interesting because they were – of course – used before prescribing Ritalin. Many child psychiatrists had laughed at me when I cautioned usage of this job, claiming it was the safest medication ever invented. Once – at the peak of my massive weight — an endocrinologist offered me a prescription of Meridia, to get rid of my excess weight.  He did not think the fact that there had been a “few” reports of sudden death should get in the way of my using it. Read more on Sudden Death in Psych Patients — From Medicine…

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I’m nowhere near what anyone would call a “News Junkie.”  My husband, a former newspaper man, often calls my attention to articles of interest and I see headlines occasionally on various web pages, such as Yahoo or Google. But this type of story seems to come up pretty regularly any more.

Yes, most people in our country are in terrible shape.  I probably harp about it more than I need to.  But remember what Mark Twain (another newspaper man) once said:

“Everybody talks about the weather, but nobody does anything about it!” Read more on Who Needs Wonder Drugs? We Have Vitamin C!…

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The next person to see me made a dramatic entrance. First, she had gotten a head start on her crying in the waiting room. But more than the sound of her crying and sobbing, she could barely make it through the waiting room door. I am no good at guessing someone’s weight.  She later admitted to being 380 pounds.  I took her word, as our clinic’s scale only went to 300. Her general appearance was that she was swollen with water – a human sponge.  The edema bloated every part of her body, and her crying eyes were nearly swollen shut. I started by asking her when her problems began.  She was now 42, and said she had thought everything was okay until age 15, when she had been raped by a “friend of the family.” This man was not really a friend, he was a person who went to the same church.  Moreover, he was a Sunday school teacher.  You would think that by now everyone would know that being a Sunday school teacher does not make someone a saint.  But this family had not yet figured it out. In many such cases, this type of person is shielded by the religious community, and even the victim’s parents are often in denial.  This woman was lucky. Her parents told her that they were going to prosecute this sinner to the extent of the law.

There was a trial, and she had testified.  She thought everything had turned out great, and so did her parents. The rapist was convicted and sent to jail. Again, those who are experienced in these things know that this type of trauma is never over quite so easily. The woman went on with her life and ended up in a really abusive relationship — the kind where someone locks you up and won’t let you leave the house and beats you if you look out the window.  By the time she got the courage to escape this living hell and seek a shelter, had a peck of kids. They lived in this shelter for over a year before she found that she had what it takes to start over.  She went to school, gained some clerical skills, and started over. She was actually doing pretty well until something happened that triggered a demon she didn’t know had possessed her. She was called for jury duty and went, with pride, wanting to do her civic duty.  She couldn’t.  She had a panic attack as soon as she entered the courtroom.  She ran to the ladies’ room, threw up, and tried to enter the courtroom again – and it was even worse. People thought she was having a heart attack, and they sent an ambulance for her.  I do not recommend this means of getting out of jury duty, although it sure worked for her. Read more on Murphy’s Law Of Medicine At Work…

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Why would a pharmaceutical manufacturer want to change a drug from prescription to over the counter (OTC)?

Well, one thing I’ve learned in my lifetime is – When the Question is “WHY?” then the answer is “MONEY.”

Prescription Drugs Go Over The CounterIn this case, the most obvious reason is more money for pharmaceutical companies.  I certainly cannot think of anything — I mean any way shape or form — that can benefit patients.

Oh, sure – in our economically-ignorant country, many people think – “Whee!  I can buy any drug I want without spending money on a doctor’s appointment and without having to get a prescription! ”

These people are prime candidates for the Darwin Awards.

Yes, believe it or not, the “RX to OTC Switch” can actually HURT patients.

Drug patents expire relatively quickly, competitors are waiting at the gates with generic equivalents, and when a drug becomes OTC, there is a chance that insurance does not cover it.

This makes insurance companies and government programs (Medicare, Medicaid/Medi-Cal, etc.) very happy.  They are so strapped for cash that even paying for a cheaper generic is a strain on the budget.  When this kind of money is involved, you can bet that lobbyists are pressuring the government to ease their restrictions so that drugs once considered risky enough to warrant a prescription so that not just anybody can have access will be available to anyone who can walk into a drug store or click on a shopping cart on the web.

Patients will have to pay for OTC meds in cash money and doctors usually do not bother prescribing an equivalent drug.  If they do not already know of an equivalent, they will probably — and generally do — just tell a patient to go buy it over the counter.

A patient who cannot afford the drug will go off it.

OK – so what’s the big deal if a cold medicine, allergy remedy or hair-restoring pill is no longer a prescription drug?

Read more on When Prescription Drugs Go Over-The-Counter…

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A Minneapolis nurse was accused of stealing pain medicine from a patient.  She had a fentanyl habit to feed, and didn’t seem to mind that it left her patient in substantial pain. Unfortunately for her, the patient was a Dakota County Sheriff’s Deputy.

Some women just make bad choices.

The reason I bring this up is not to wonder about if this woman is guilty or not.  I can tell you that I share one opinion with the judge — that people who ask for a lot of continuances may be getting everyone angry. Read more on Addiction And Nurses…