Please stop flushing!

I have always thought as I hear of someone "flushing their old prescriptions down the toilet" that something would come of it.  Not only that, but the thought of tiny amounts of antibiotics in our water supply really creeps me out as to what else is in there that is not removed through normal processes? And it's not only the flushing of meds... it's also the excretion of medications, sometimes unchanged or even unchanged in active metabolite form, in urine and feces. 

YUMMY!

From the AP regarding vaccine and autism link

I'm sure there are a lot of people reading this one today. 

ATLANTA (AP) — The parents of the 9-year-old girl who won a government settlement described how their hearts were broken as they watched their bright, red-haired daughter deteriorate into an irritable, odd-behaving toddler after she got several childhood shots.

"Suddenly my daughter was no longer there," said Terry Poling, the girl's mother, in a news conference Thursday. She and her husband Jon said their daughter, Hannah, has been diagnosed with autism.

The government has agreed to pay the Polings from a federal fund that compensates people injured by vaccines. U.S. officials reject the idea that the vaccines cause autism, but they say that in this case the shots worsened an underlying disorder that led to autism-like symptoms.

The Polings said five simultaneous vaccinations in July 2000 led to Hannah's autistic behavior. She was about 18 months at the time.

U.S. health officials have consistently maintained that vaccines are safe, and a lawyer representing them said this week that there was no change in that position.

"Nothing in any of this is going to change any of our recommendations" about the importance of vaccines for children, said Dr. Julie Gerberding, who heads the Centers for Disease Control and Prevention. "Our message to parents is that immunization is life-saving."

In Polings' first appearance since the case became public this week, the Athens, Ga., couple acknowledged their legal case never got to the point where evidence was introduced or argued.

They called on the government to remove thimerosal — a mercury-based vaccine preservative — from all flu shots. Thimerosal has already been removed from other vaccinations given to children.

"Why take a chance?" asked Jon Poling, a 37-year-old neurologist.

The Polings, accompanied by Hannah, said their daughter was a bright child who could whistle on command. But almost immediately after the vaccinations nearly eight years ago, she because feverish and irritable. Then, her behavior gradually changed so she would stare at fans and lights and run in circles.

"It wasn't like a switch being turned off. It was more like a dimmer switch being turned down," Jon Poling said.

Government health officials conceded that the vaccines worsened an underlying condition and that she should be paid from the federal vaccine-injury fund.

Autism advocates called Hannah's case a "landmark decision," although the Polings' own attorney disputes that.

"This was not a court decision," said Clifford Shoemaker, who is based in Vienna, Va. The U.S. Department of Health and Human Services conceded the case before the court was asked to make a determination, he added.

Government officials wouldn't discuss why they conceded this particular case, but said people with pre-existing injuries can obtain compensation under the program if they establish that their underlying condition was "significantly aggravated" by a vaccine.

Medical and legal experts say the narrow wording and circumstances probably make the case an exception — not a precedent for thousands of other pending claims.

Hannah has a disorder involving her mitochondria, the energy factories of cells. The disorder — which can be present at birth from an inherited gene or acquired later in life — impairs cells' ability to use nutrients. It often causes problems in brain functioning and can lead to delays in walking and talking.

The Polings were exploring two theories about what happened to Hannah. One is that she was born with the mitochondria disorder and the vaccines caused a stress to the body that worsened the condition. The other was that the ingredient thimerosal caused the mitochondrial dysfunction, Jon Poling said.

Since 2002, the preservative thimerosal has been removed from shots recommended for young children, except for some flu shots.

Another indication

FRIDAY, Feb. 29 (HealthDay News) -- The U.S. Food and Drug Administration has approved Abilify (aripiprazole) to treat manic and mixed episodes in children aged 10 to 17 with bipolar 1 disorder, makers Otsuka Pharmaceutical Co. and Bristol-Myers Squibb Inc. said Friday.The drug has been approved for this and other uses in adults for several years.The new approval was based on results from a four-week study involving children in this age group. The trial demonstrated the drug's effectiveness compared to a placebo, the drug companies said in a statement. Abilify was first approved in November 2002, and nearly 15 million prescriptions had been written through December 2007, the statement said.

Why Does it Take So Long to Fill My Prescription?

The age old question that used to make my toes curl...  why does it take so long to fill my prescription?  If you search around the net, you'll find non medical people discussing, and it's hilarious: Why does it take so long to refill my prescription?  I went there yesterday and it took them 2 hours to refill my medicine.  I wanted to call the manager to complain but thought I'd ask here first.

Yahoo's best answer voted (not kidding):  If they did it in 2 minutes, you wouldn't value them as much. You'd think that they were just technicians putting pills in a bottle.

They have to make you wait to preserve the mystique.

Yeah, that's it baby.  We need more value?  We love mystique.

Basically the bottom line is that there are hundreds ahead of you!

Baxter Recalls Heparin Products

Baxter International recently announced a voluntary recall of all remaining lots and doses of its heparin sodium injection multidose and single-dose vials and HEP-LOCK heparin flush products.
The FDA has received 448 reports of adverse events associated with heparin products, but some of these may be duplicate reports. In 389 of these cases, Baxter was named as the source of the product. The reports included 215 “events of interest” and 21 deaths. Most of the events occurred last year.

The FDA has launched a “far-reaching investigation” of a Chinese firm, Changzhou SPL, which made the active pharmaceutical ingredient (API) for Baxter, Michael Rogers, director of the FDA’s Division of Field Investigations, said. Two FDA inspectors were sent to China to carry out that investigation and related investigations of two “consolidators” associated with the API manufacturer. They also may inspect workshops and farms associated with the manufacture of the product, which uses pig intestines.

The agency has posted on its website a redacted version of the Form 483 observations that its investigators issued after inspecting the API plant. It can be accessed at www.fda.gov/ora/frequent/483s/Changzhouspl_heparin_20080226_483.html.

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It's the backdoor method of the Chinese trying to kill us.  Just kidding.  Seriously though this recall does affect the hospitals where I work pretty severely.  When do you think we'll stop relying on foreign countries to make a medicine that can be trusted?

Paternity Testing Available More Discreetly

Friday , February 29, 2008

By Marrecca Fiore

Who needs Maury Povich when paternity tests are now available at Rite Aid, Meijer and other pharmacies for just $29.99?

The Identigene DNA Paternity Test Collection Kit was first rolled out in Washington State, Oregon and California in November last year, according to Rite Aid spokeswoman Ashley Flower. The company continues to evaluate whether it should expand the kits to other states, she said.

According to the Identigene's Web site, the tests compare genetic information obtained from cheek swabs collected from both the child and the father. The swabs are then sent to the company's laboratory along with a $119 lab fee. The results are mailed within five business days.

While the tests are believed to be accurate (the company's Web site says they're 99 percent accurate), there are some reasons why women and couples may want to consult a professional laboratory for paternity tests, said Brad Imler, president of the American Pregnancy Association.

"There's no risk of harm from a medical standpoint," he said. "Although they're not admissible in court. And, from an emotional standpoint, it's a good idea to see a professional. It doesn't have to be a doctor, but someone who is prepared to discuss the result with you if it comes back in a way you were not expecting."

Imler said some people, especially married couples, may find the results of paternity tests traumatic.

"Whatever the circumstances are that bring someone to the point of needing a paternity test, that's irrelevant," he said. "The professionals associated with the laboratories are trained to present the results in a way that doesn't cause panic or in a way that reduces panic."

Both Rite Aid and Identigene representatives say the tests have brought no more controversy than at-home home pregnancy, blood pressure, cholesterol and drug tests did when they were first introduced.

"There was a lot of concern when the home pregnancy test first came out," said Douglas Fogg, chief operating officer for Identigene. "Would people use it correctly? Would people be able to handle the results?

"We have been providing home DNA testing since 1993 and on the rare occasion we'll have a client that has a hard time dealing with the results," he continued. "Most of our clientele are aware of what the results will be. They don't want to involve lawyers or physicians. They just want confirmation in a quick, easy and confidential way."

Fogg said the company’s Web site provides consumers with counseling information

"Some people are devastated by the result of a paternity test," he said. "A paternity test can have a life-changing result. For those that need professional help in dealing with their situation, our Web site offers references to family counseling services that can provide people with the help they need."

Fogg said 60 percent of Identigene's clients are females. Some users are looking to confirm their own paternity. Almost 30 percent of purchasers buy the test for someone other than themselves, according to the company's own surveys.

The tests are sold in 1,000 pharmacies nationwide, Fogg said. He said all pharmacies have reported sales and the company is pleased with the interest. The tests are also marketed online and through resellers.

Questions asked...

- What are the typical work hours of a hospital pharmacist? Well in my case, it kind of depends on what shift you get.  Since hospitals are open 24/7, including holidays and weekends, someone is working early day shift and others 2nd and 3rd shift.  At one hospital, we had some pharmacists working 12 hour shifts (3 - 12 hour shifts) a couple that did 3 - 13.5 hour shifts to get the 40 hour per week.  I personally worked four 10 hour days - 7am-6pm (hour lunch).  I worked every fourth weekend.  Now the weekend rotation probably depends on the particular hospital.  The holiday rotation was usually two per year for me.  Christmas/July 4th, Thanksgiving/Memorial Day, etc...

- What are the common working schedules?

Typical 1st, 2nd, and 3rd shifts as mentioned above

- Is the method of income for hospital pharmacists in anyway related to Medicare reimbursement schema? If it is, I’ll never erase this cringe on my face :[…

Never has been related.  I made a salary (not hourly).  Today, I'm hourly working from home - with 7 hospitals and has nothing to do with medicare reimbursement or any other insurance situation.  In fact, I make a dollar amount per hour and actually time + half for anything over 40 hours per week.  The other hospital job was a straight salary; however, you could make something similar to time+half to volunteer for more.

- It seems to me that all this hype about shortages of available pharmacists is only the result of retail chains opening more stores than can be staffed. How is the job availability for hospital pharmacists?

In my particular area, there are always jobs available.  It really depends upon the area I believe.  I'm in a city that has 10 or more in a 60 mile radius.

- And last but not least, if people disdain retail pharmacy so much, why do most people choose it? Correct me if I’m wrong, but most graduating pharmacists sign up for retail right?

Hmmm...  I guess they do.  The money is enticing...  also the sign on bonuses alone can erase some student loan debt.  Other pharmacists really like people interaction and retail is all they knew prior to pharmacy school.  Some students do not enjoy the hospital environment.  Please keep in mind though, hospital and retail are only TWO of the many many opportunities.

Thanks a bunch! You wouldn’t imagine how much your responses mean to me. I can hardly dig up any information via Google.

Is It That Bad?

A potential pharmacist student commented on my blog here asking me if pharmacy was really that bad... he said he was reading blogs about the medical profession and all we do is gripe and complain. Got me to thinking this early morning about that question... "Is it that bad?" For me, no way it's not that bad or I would have already gone back to school to do something else. I believe it's human nature to complain some and especially to complain anonymously. Things about pharmacy that I have loved... This is a list probably needed to be completed to tell you guys and gals the GOOD stuff.

1. If you loved science and you loved biology in high school and college then pharmacy could be the career for you. Not only did I have the opportunity to learn about chemicals, etc..., but I learned the various ways they are changed, metabolized, and excreted by the human body. Not only that, but the different ways they can be broken down by DIFFERENT human bodies - some with renal issues, some with hepatic issues, etc... Everyone can be truly different. Drugs can react differently. I found this one single point of pharmacy to be quite fascinating.

2. If you want to graduate in 6-8 years and start out making six figures (potentially) this may be the job for you. I found in 1999 when I graduated that I was making close to six figures, but a lot of the older pharmacists were really ill about the new guys on the block because they knew we were making the exact same pay. It wasn't pay based on performance but LICENSURE. For the new guy, this is great; for the old guy, it can be disheartening to think that little youngin' next to you is bringing home the same bucks. I'm almost 10 years out of pharmacy school now (unbelievable time flies!) and it STILL DOES NOT BOTHER ME. I don't get wrapped up in petty stuff, and I figure if you really want a dollar more per hour, you could have negotiated up front. BE A SHARK when you negotiate - ASK FOR THE IMPOSSIBLE. If you do not ask, you will NOT RECEIVE. Vacation... they say we'll give you 3 weeks. Tell them that you want 4 weeks. Go up on pay by at least 5-10K per year. Why not? They want you and they will negotiate just like if you are selling a house.

3. Options other than retail. When I tell people I'm a "pharmacist," the majority think retail. What is great about pharmacy is that there are MANY MANY options in different jobs. Of course coming out of school, retail is the most lucrative in pay, but over time other positions can be just as tasty. There are the hospital pharmacists (me), the home infusion pharmacists, the nuclear pharmacists, the retail pharmacists, the professors in a pharmacy school, the long-term care pharmacist, the consultant pharmacist, and the specialty pharmacists within other settings. You can do a residency, make yourself a little different than Joe PharmD next to you, and land a Critical Care Specialty Pharmacist position at a big city hospital, make rounds with a physician that actually respects you if you know your shit and drink Starbucks coffee everyday leaving for home at 5pm like the rest with bankers' hours. The CHOICES ARE ENDLESS really.

I've been out of school, like I said, for 10 years almost. I have tried retail, home infusion, long-term care, and hospital. I love little bits of all of them... but I find hospital to be the most comfortable for me.

I would never tell someone to NOT pursue pharmacy. It's a great career for anyone... BUT you will find some complaining out there... even from me.

Blogs have to be funny after all, right?