Category Archives: Drug Trivia and Rants

MRSA is going to end the world…

Another typical example of the media getting a hold of a medical concept and completely instilling fear and chaos into the unwashed masses.
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Everyone is playing chicken little throwing MRSA around and implying that its somehow a death sentence if you get it. This magical strain of staph is resistant to everything short of a blowtorch and will not only kill you, but kill your children and make your minority cousins horribly disfigured.
Lets be realistic here. MRSA is nowhere nearly as bad as people are making it. For those at home living in a box, MRSA stands for Methicillin-resistant Staphylococcus aureus. Yes, it sounds extremely scary. People think that MRSA is resistant to everything, and there is no hope of treatment.
They are wrong. They are in fact extremely wrong.
First off, I have never ever seen a MRSA case that has been resistant to everything under the sun. Yes, MRSA is resistant to all of the penicillins/cephalosporins, but we aren’t living in the dark ages here, we have a shitpot more antibiotics than those two classes. Of the dozens and dozens of Culture and Sensitivty reports that I have gotten trying to get Zyvox covered, I have found that in 99% of the cases the “evil” MRSA infection is perfectly suspectible to the Fluroquinolones (Levaquin/Cipro/etc), Tetracycline, Clindamycin, Rifampin, SMZ/TMP, etc. If you want to go IV route, Vancomycin.
Seriously, its not that big of a deal. The problem is that people want to throw Zyvox at everything instead of doing a proper C&S report to determine what else they can use other than the biggest bacteria bazooka that is on the market (at $60/tablet no less). Give them Zyvox, send them home and forget about them. Right, you try to explain that to the insurance company when they are staring at the C&S report that I faxed them showing that clindamycin has exactly the same efficacy as Zyvox in this case. Retarded I tell you, utterly retarded. The PA’s that I have gotten for Zyvox involved a ton of confirmed type-1 allergic reactions to what was effective. If you have drug allergies then you start stripping of available agents and things get a bit complicated.
So I blame the media here (as always) for clipping out only choice words that will cause the most fear and panic (read: ratings) and have patients come in to me in a tizzy thinking their life is over because they have a stupid minor MRSA infection.

The wonderful world of drug handouts

Once in a while, you’ll get a patient handout for a drug that just cant help but make you laugh. Patient handouts are meant so even the village idiot can get their meanings. Lets take a look at Xeloda’s patient information sheet and angrypharmacistize(tm) it.
STOP TAKING XELODA IF YOU EXPERIENCE ANY OF THESE SIDE EFFECTS
yell.jpg

Your tech starts giving you lip.

throwup.jpg

You start to have conversations with your poop.

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You decide to only communicate with your tech using the universal pimp-slap.

nightpoop.jpg

You decide to take a poop without pulling up your nightgown.

poop.jpg

You can only poop in your nightgown under the moonlight.

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You kick all the crackheads out of your store.. Literally.

moustache.jpg

You grow an evil villan mustache

Pharmacists, Narcs, and why you think we’re assholes

Some people think that pharmacists are assholes. Funny how these are the same people who want their 30 day supply of Vicodin filled after 10 days. I’ll just give you all at home an insight as to why we are the way we are. If you’re a pharmacist at home (or play one on TV) comment and help me out. 🙂
— What makes us angry —

  • We’re lied to almost all day. My medication got lost/stolen/flushed/eaten/left on vacation/etc. The list goes on and on and on. So when you come and want an early refill for your pain medication and give us that excuse; unless you can prove otherwise (first time its happened, you get 30 other maintenance meds at our place, we /know/ you), we’re going to think you are full of shit. Thats just the way it goes. You think we get smoke blown up our asses every day of work and aren’t jaded because of it?
  • We are people to. We like to be talked to, to asked how we are doing. All day I get screamed at because the doctor didn’t okay pain pills or soma. You reap what you sow, and if you throw shit in my face then i’m going to throw it right back.
  • If you /only/ pick up vicodin/soma/valium at my store (like 5 years going back of nothing but vicodin/soma/etc. You all at home know those kind of profiles), we’re going to give you looks when you come in. We’re also going to have assumptions when this is the 4th month in a row you need them early because of some bizarre excuse. We understand shit happens, but if you’re telling us the truth, then I dont want you in the store because a meteor is going to land on you. Oh, did I mention that we also know you pick up your hypertension meds at another pharmacy?
  • If you are going to sell your fucking vicodin, dont leave it in the fucking bottle you picked it up in for the police to see. We dont like seeing policemen walk in holding our vial saying “Did this person pick this up here? Heres a subpoena, have a nice day.”
  • If you have the balls to pick up your soma, turn around and hand 2 pills to each of your friends IN THE STORE, we’re going to boot you. Plain and simple. Diversion is always assumed but extremely hard to prove except if you are a fucking idiot.
  • When I have to tell you 10 fucking times that your pain pills are EARLY because you are too stupid to divide 90 by 3 to find out WHEN they are due. Then argue with me about it!
    Notice a trend here? All deal with narcotics. Think about that. Now:
    — What makes us Happy —

  • When you bring in that Rx for Vicodin, and you tell US right off the bat “please put this on file, i’ll pick it up when its due on the xth”.
  • When you are a true chronic pain patient who comes in on the day that he/she is due (or maybe a few days late) with a new Rx, waits patiently, and never ever asks for anything early. If there is a snag with your insurance/work comp; you are very polite and helpful to get it resolved.
  • When you treat us like human beings who care for you and not a licensed dope dealer who you can swear at when things go your way.
  • When you get your pain pills changed, and you bring back THE OLD ONES for destruction and to pick up the new strength.
    So really, it boils down to honesty and taking medication how its prescribed.

  • Addiction vs Dependence

    I know with the latest Oxycontin crap hitting the fan, people are throwing around the word “addiction” like its going out of style. Let me clarify a few points here.
    Addiction is NOT the same as Dependence. People associate withdrawal symptoms with addiction. Fact of the matter is, it appears with both. Example:

  • Patient is on a beta-blocker for years and years. You take away the beta-blocker and guess what, they patient goes through withdrawals (higher heart rate, higher blood pressure, etc).
  • Patient is on Fentanyl patches for chronic pain. You take away the patch, and bingo, withdrawals.
  • Patient is on avandia and you take it away because you’re dumb and think its going to suddenly kill the patient. Guess what, withdrawals (higher blood sugar).
    Withdrawals is the body’s natural response to a sudden change in receptor block/activation. If I dump 500mg of atenolol into someone, they are going to have (among other things) a very abrupt reaction. Because I am not withholding medication, its not really withdrawals, but it illustrates the same principle.
    Now lets look at Addiction. The basic difference between the two is mostly psychological. Why are they taking it? Are they taking it for a euphoric effect or are they taking it so they can live a decent quality of life with a broken back/cancer pain/whatever.

  • A person who is addicted will snort oxycontin illegally, and do illegal things to obtain more oxycontin so they can get the same high. If you buy your oxycontin on the street to snort/crush/inject (ie: take it how it was NOT supposed to be taken) you are an addict.
  • A person who is dependant on oxycontin takes it as prescribed and lives a normal quality of life. They will bitch and moan if the drug is discontinued, but will generally work with you to move to a different agent.
    Now the line gets blurred by patients who are on narcs for legit reasons, but their pain is uncontrolled, so they take it upon themselves to go and doctor/pharmacy shop to obtain more to control their pain. Even if it resorts to doing illegal things.
    Nothing fries my wires more than having some doctor refuse to prescribe oxycontin or fentanyl to a chronic pain patient because they are afraid they will be “addicted”. Sure, and giving them 200 Vicodin ES/month (wtf?) and blowing out their liver is the correct way to go. Theres a reason why these things are C2 narcotics. They have very abrupt and euphoric effects and guess what… THEY ARE REALLY REALLY GOOD FOR CHRONIC PAIN! Of course trying to explain this to a doctor is about as useful as a debating with a turd. They just get all pissy and hang up (so much for “patient care”). Then you have the patient ask the question “Will I become addicted to these?” The answer is “If you are dosed correctly, you will become dependent on them to live a normal quality of life. Its like insulin or any other medication.”
    Sometimes it just amazes me as to how much fear doctors put in patients that is 100% unwarranted and unneeded. Maybe it’s just a CYA move, but it ends up doing tons more harm than good. So there you have it. Be it right or wrong (in your opinion) thats my take on Addiction vs Dependence.

  • Oxycontin, addiction, and general stupidity

    So, it looks like Purdue got dinged like 600 kerzillion dollars because “misleading the public about the painkiller‘s risk of addiction”. There are websites cropping up about class action lawsuits against the company, blah blah blah.
    AMERICA! THIS IS WHY THE COST OF YOUR MEDICATION IS SO FUCKING HIGH!!! You think a bullshit lawsuit like this would fly in Canada or Mexico? NO! Lets sue God because water could be misused and we could drown in it.
    The article is here:
    Now I’m not siding with Purdue one bit, but I think the doctors themselves are partially to blame. Purdue got dinged because they were “claiming to doctors that OxyContin was less addictive and less subject to abuse than other pain medications.”
    One question. If that was the case, why is it a C2 and not a C3 or C4? Doctors, get your head out of your collective asses and start using COMMON SENSE rather than listening to dumbass drug reps. Oxycodone has been out for a bazillion years. Why all of a sudden would it become less addicting/habit forming/etc just because its in an extended release tablet? How can you expect a morphine analog that has a lower first pass clearance than morphine to be LESS addicting/habit-forming/etc? Here, I have this nice drug called Heroin thats a less addictive alternative to morphine (its a joke, if you knew the history of heroin you’d understand) AND I have this wonderful bridge for sale! Gimme a break. When Oxycontin came out I could see a mile away that people were going to be hooked on this stuff. I saw it with MSContin too. Thats why its a C2 people! High potential for abuse! Same class as cocaine!
    If I were a doctor, this is how the conversation would go:
    HotRep: Doctor, this Oxycontin is a less addictive pain medication.
    Me: O RLY? Why is it a C2 then?
    HotRep: Well, because it has a high abuse potential, but its less than morphine.
    Me: Oh, if its more bioavailable than morphine, then how does it make it less abusive?
    HotRep: Dont make me explain this to you *bending over to show her clevage* Have some free pens and pads.
    Me: YES! I SHALL WRITE FOR IT FOR ALL MY PATIENTS!
    HotRep: I knew you’d see the light.
    Heres what gets me:

    Attorneys for the three executives said giving them criminal convictions was punishment enough, and noted they were charged because of their job titles, not because they themselves promoted OxyContin as a drug with little addiction potential.
    The speakers, many of whose children died after trying the drug only once, disagreed.
    Nuss held up a stone urn slightly larger than a pill bottle that she said contained her 18-year-old son‘s ashes.
    “By pleading guilty they acknowledged that doing nothing was not good enough,” Assistant U.S. Attorney Randy Ramseyer said. “We cannot bring those people back. It‘s not something this case can do.”

    Oh, I’m sorry. Your child died after he ABUSED A C2 NARCOTIC. Gee, go figure. Maybe you should stop blaming other people for your child’s death, and start blaming your CHILD and YOURSELF because you raised an IDIOT who couldn’t say no? Lets sue Clorox because little Jimmy drank a bottle of bleach and died. Am I the only one here sane enough to realize that people have a huge problem with taking personal responsibility for their actions here? How could Purdue even remotely be responsible for a child’s death after he/she got Oxycontin ILLEGALLY and abused it? Should the drug magically know that its being used in a child and not work? What in holy fucking hell are people thinking here? Has the world gone mad? Do people think that these drugs are safe?
    Wait, this gets better:

    Survivors of the victims want the Food and Drug Administration to reclassify OxyContin for use only for severe pain. The drug currently can be prescribed for moderate pain.

    Arrrrg!! Im dying here! Moderate vs severe pain? How can you tell? If I get my skin ripped off, am I classified as moderate or severe? Now comparing this with getting my nuts slammed in a drawer I would have to say I am in moderately severe pain. Lets put a label on something that is very person specific.
    So next time you’re bitching as to why your medication costs $300 bucks a month, think of this and all the lawsuits that are going to be flying around. Oh, and when your loved one is dying of cancer pain and your doctor only prescribes him Tylenol #3 or Norco for fear of being sued, this is why.

    Avandia – Oh why are people so stupid.

    **WARNING! Avandia and other prescriptions are hazardous to your health, and only should be prescribed and dispensed under the supervision of people who went to a collective of 15+ years of college and who KNOWS what the hell they are doing. This is because Rx drugs are DANGEROUS and require KNOWLEDGE to use effectively****
    Duh right? Obviously not.
    So Avandia is being tied to causing MI’s and related deaths in their patients. Lets look at some facts shall we. I bet the media isnt picking up on these:

  • Look who funded this “Study” (from http://content.nejm.org/cgi/content/full/NEJMoa072761) Dr. Nissen reports receiving research support to perform clinical trials through the Cleveland Clinic Cardiovascular Coordinating Center from Pfizer, AstraZeneca, Daiichi Sankyo, Roche, Takeda, Sanofi-Aventis, and Eli Lilly. Dr. Nissen consults for many pharmaceutical companies but requires them to donate all honoraria or consulting fees directly to charity so that he receives neither income nor a tax deduction. No other potential conflict of interest relevant to this article was reported.
    Yeah, does anyone else see something wrong with believing a study that was funded by the COMPETITORS of GSK? Im sure Dr. Nissen doesnt get ANYTHING from these companies. No sir. He probably doesnt get to use their houses in the Bahamas on their corporate jets and eat with the offical Pfizer credit card. Charity my ass.

  • Amazing how they didnt include trials that showed no deaths: Six of the 48 trials did not report any myocardial infarctions or deaths from cardiovascular causes and therefore were not included in the analysis because the effect measure could not be calculated. You think maybe that skewed the data a bit? Lets not include the studies that showed no risk, just the ones that did. Way to go douches.
  • The population this is being tested against is already at risk for having a heart attack. Its very well knows that Diabetics are at risk for stroke, Heart attack, Renal Failure, blah blah blah. Water is wet, the sun rises in the morning. Why is this such a big issue?
  • These risks are included in the package insert of Avandia, and are KNOWN risks, and have been known since the drug came out.
  • http://content.nejm.org/cgi/content-nw/full/NEJMoa072761v1/T3 Nice chart of all of the results. Notice the differences between placebo and Avandia? See how they are almost identical? So if you have say a p value of 0.05, and your study has 200 people in it, that 5% error margin is a lot of people. See where this is going?
  • The Lawsuits are already gearing up. AMERICA! WAKE UP! THIS IS WHY YOUR MEDICATION COSTS SO MUCH! SO DRUG COMPANIES CAN SURIVIVE BULLSHIT LAWSUITS BASED UPON ‘STUDIES’ BY BULLSHIT DOCTORS WHO SPEND MORE TIME GETTING KICKBACKSINCENTIVES BY THE DRUG COMPANIES AND STROKING THEIR OWN EGOS THAN ACTUALLY PRACTICING MEDICINE.
    Yes, Dr. Nissen, I’m talking about you. You and your flawed ‘study’ is causing me, my colleagues, and the doctors (who actually work and see patients) hours upon hours of time explaining to people why your study is no cause for alarm and they should NOT stop their Avandia without talking with someone with a clue (their doctor). You should be ashamed for causing so much useless and pointless panic over something that is (in the scope of things) retarded and unwarranted. I hope someone tears your ‘study’ a new asshole and points out the glaring flaws. I know you probably dont work for a living actually helping people, so i’ll give you a little pointer: Prescription drugs are dangerous, henceforth why doctors can only write them, and I can only dispense them. I know this is a foreign concept to you, but think about it next time you’re on that jet getting lapdances from the Lilly reps.
    In short, Americans want to listen to the media, who obviously know a lot more about medicine than their Pharmacist, their Doctor, or Nurse. I say if they dont want to take Avandia, thats fine, they can die an early death. Thin the herd a bit. Sometimes we need to take the warning stickers off of things and let nature run its course.
    Sorry this isnt more rantilicious. I’m gearing up for the NPI cutover clusterfuck that I know is going to drive me to an early grave tomorrow.

  • Albuterol HFA – What the hell?

    As you all probably know, good old albuterol (with CFC’s) are no longer being made. No longer can we get an Albuterol MDI by Warrick for 9.95. Now we get “environmental friendly” pieces of shit for $20/each.
    I recieved a phone call from a friend of mine who works in the People Republic of California. He told me that the state Mediaid (Medi-Cal) program decided (with their infinite wisdom) to take every albuterol MDI off of formulary. Thats right, he said no Ventolin HFA, no Proventil HVA, no ProAir HFA, nada.
    You know whats covered? Xopenex HFA. 29.99 a pop too. What makes it even better? The company cant supply them fast enough to meet up with the demand of California! I laugh at him! Ha Ha! Oh, get this, they wont accept prior auths for albuterol either! Ha Ha^2! Guess patients are screwed there! Ha Ha^3! Who needs ‘clinical data’ or ‘efficacy’ or ‘studies’ when you put on your formulary the product that will give you the biggest kickback, er.. rebate. California (like Camelot) is a looney place!
    So the FDA is saying that you cannot switch a patient from a CFC MDI to an HFA MDI without a new Rx. They are not equivalent and require a doctors OK to switch. They also say that all of the different HFA MDI’s arent interchangeable. I laugh at that too! You know how much bitching we would get if we faxed every doctor saying “Is it okay if we switch this CFC MDI to HFA MDI?” They’ll say “Are you retarded?”. I mean think about it; what doctor is going to say “NO! I DEMAND A CFC MDI! I KNOW THEY AREN’T BEING MADE! COMPOUND IT PUNY PHARMACIST!” Pretty retarded if you ask me.
    But what do I know, I only have to hear the complaints.

    “Medical” Marijuana

    Now the last few entries haven’t been very angry. This one is to make up for that.
    How many of us have been merrily working along, to have some fucking douchebag come into your store and ask if you stock “medical” marijuana? How many of you have had said douchebag argue with you when you say that marijuana is illegal to have on the basis of “I have a prescription”.
    Let me clear the air here. Marijuana is a C-I substance. It is illegal. End of story. Cocaine is a C-II substance, cocaine is legal with an Rx!
    I don’t care if you have an Rx from some quack in some hippie-dirt-eating-town like San Francisco or Seattle. I don’t care if you have a letter from God himself saying “Thou Shalt Smoke The Weed”. Its fucking illegal. Let me repeat it again because you were baked the first time I said it; its fucking illegal. Don’t care what your city says, what your county says, what your liberal fruity-motherfucker mayor says, its illegal. State law cannot relax a federal law, get used to it.
    Where do people get off arguing with me about this shit? I could care less if there is a clinic down the road that sells it for “medical purposes”. A quick call to the DEA and that clinic wont be around for much longer, why? ITS FUCKING ILLEGAL TO GROW OR SELL MARIJUANA! Is prostitution legal for people with erectile dysfunction (with an Rx of course)? Think about that one for a while.
    Now I know that people are going to blow me shit about how you have “glaucoma”,”wasting”, “blah blah chronic pain”, “blah blah you dont know how it feels” that require smoking out three times a day. My response? There are a whole shitpot full of other agents out there that are safer, cheaper, and work a whole lot better than smoking out. Stop using those lame ass cop-out excuses and stop inviting me to your pity party. Go see a “real” doctor and get a “real” Rx for some Soma or Vicodin instead of going to a quack and getting an “Rx” for some pot. I may not know how it feels to need pot, but you obviously don’t know how it feels to be annoyed while you’re trying to work (you know, work? The thing you don’t do. A job? Ring any bells?)
    When you’re 24 years old, reek of pot walking in the front door, then stumble over your words saying that you have glaucoma and HIV/AIDS wasting (when you’re a good 260lbs) and you need some marijuana, it makes me want to kick you in the face and give you a real reason to smoke out everyday. Then you hand me your medicaid card which really makes me mad that you’re doing this shit on my tax dime!
    And for god sakes, quit arguing with us about the legality of it! You’re a stoner hippie (still living with your mother) arguing with someone who’s not baked, went to college, has use of most of his brain still, can remember things for longer than 3 mins, and legally deals drugs for a living! In fact, you wont remember this conversation 10 min’s from now (but your glaucoma will be excellent!).
    God help us if they decide to make pot legal. If you think Americans are fat and lazy now, imagine when a good majority of the population is sitting around eating Big Macs and smoking out all day. Oh wait, thats our welfare system. Sorry about that.

    The Gospel according to Me.

    I’ve seem to have made a few doctors upset with my last few posts. I want to help clear up some confusion about this blog, and other items of interest. I type at over 40 wpm, so expect grammar and spelling errors (yes, i’m talking about you grammar nazis out there).

  • This blog is the distilled down anger of the profession of pharmacy. This is the kind of stuff that really annoys us pharmacists. This is an insiders look at the profession. No matter where you work you’ll find that we all get annoyed by this
  • The statements made are just generalized. Seriously, take it with a grain of salt. Its meant to be angry and postal. This isnt my day-to-day life here, just aspects that really irk me.
  • I am no way this angry at work, nor treat my patients like this. I do however refuse to fill narcotics early and stand my ground using a firm and polite tone. If they want to get it filled somewhere else, thats fine. Doctors (and their staff) know that when they put down “Do Not Fill Until 2/5/07” that the patient will not get a single tablet until 2/5/07. Doctors respect that, I’m not a cave-in who can be threatened for medication.
  • This blog is used to blow off steam, steam that a lot of us pharmacists generate by working with the public. As you can see by the comments, a lot of people agree with what I say. I think that says something.
  • I’m never an asshole to any doctors (when I get to speak with them). Sometimes i’ll act a bit short to get my point across, but my main concern is to get the medication covered and out to the patient in a timely manner. When I tell a doctor that drug X is covered, and he wants drug A, B, or C (and gives me no justification to even try to get a prior auth, other than ‘im the doctor, this is what i want’) it irks me. We need to listen to each other, and this blog (i hope) will help doctors understand what we deal with on a daily basis. Im sure that you wouldnt want your grandmother spending $400/month for the (not covered) latest and greatest vs having a drug thats covered thats not being pushed by some drug rep (and not even give justification for the latest and greatest)
  • When a doctor makes a drug or dosage mistake, do I tell the patient “Hey, your doctor screwed up, i need to call them to get it fixed”? No, of course not. I say I need to call for a dosage clarification. I never ever bash individual doctors to the patients. Never ever ever.
  • I am never an asshole to your office or front-end staff. They have to deal with the public just like I do, and I feel that we are in the same boat (with respect to dealing with asshole patients).
  • Keeping us in the loop really means a lot to us. Nothing makes us happier than to get a call from a doctor in town saying “Hey, I need help with patient X”. I will drop everything i’m doing to help that doctor out to get exactly what his/her patient needs. I’ll gladly research whats covered. Got a patient with CHF and not really sure what the 4-5 medications he/she needs to be on? Call me up! I’ll tell you. Wondering why that ACE-I isnt working in that African American patient of yours? Gimme a call! We know the answer! The ‘ego’ that you all say I have isn’t myself at all, its having a person who took 3+ years of pharmacology a phone call away, and ignoring our advice.
  • Pharmacy is the only profession where we aren’t paid for our time or advice. Try getting legal advice from a lawyer and you’ll get a bill. A doctor? A bill. A pharmacist, a smile and advice. Even though I may never ever see this patient, nor fill a drug (and make money) from them. Igive advice to that frantic mother at 7pm on how much tylenol to give her sick baby (whom i’ll never see) the same as I do to a patient who has been here for 20 years.
  • We are the most accessible healthcare providers. We answer the stupid questions so you don’t get a phone call or a page during dinner. I have no problems doing this for any doctor. It really makes my day when a doctor calls up and says “Hey, you talked to patient X about Y last night after my office was closed, thanks a ton!” This sounds sappy, but sometimes your local pharmacist just needs a quick call saying thanks for the work they do and the service they provide to our patients. Those simple words will really make an impact on us.
  • We are the translators of big words, and make scary sounding procedures sound not as scary. We are your translators from medical to common. We are also the translators of your handwritten notes to the patient (which they cant read).
  • We are your eyes and ears outside the office when patients go doctor shopping, or swipe one of your Rx pads. We let you know whats going on so you can take care of your ‘problem’ patient on your turf, not the DEA.
  • I treat all patients with dignity and respect. I am never initially hostile to any patient regardless of sex, creed, religion, blah blah blah. However when the 5th phone call from the same patient in a day comes asking for an early fill on vicodin, I lose my temper. I don’t lose it at them, but on this blog. I never lose my temper in front of patients, nor scream at them from across the store. I write about the 1 patient that ruins my day and not the 300 that made my day. This isn’t a day-to-day blog about a pharmacist working, its about the frustrations that come with the one asshole that walks through my front doors.
  • When a medication isn’t covered, and we ask you (the doctor) to change it to a covered medication, give us a reason why the covered wont work. We will be happy to fill out the initial Prior Auth paperwork for you just to sign. Saying “well this is what I want” isn’t respectful to someone who is trying to help you out.
  • If a new drug comes out, and you (the doctor) have a question about coverage, usability, or just want to know if its just more of the same, call us! We probably read about it in Drug Topics while taking a shit, and we’ll be really upfront with you if we think its just another money-maker for a dying pharmaceutical company. We don’t get paid by the manufacturers, so why would we lie and say the latest = the better unless we really do mean it.
  • All pharmacists have a sense of humor. Sometimes twisted (like myself), but we like a good joke, or a tounge-in-cheek comment when you call in that Viagra Rx.
  • My opinions about things are just that, opinions. “Opinions are like assholes, everyone has one and they all stink”. They don’t reflect upon the profession, other pharmacists (even though they may agree to some degree) or even other doctors.
  • I don’t belittle doctors, think they are all idiots, or slaves of drug-reps. Although I must admit the nicest (and most willing to work with you) doctors I have experienced are pediatricians, podiatrists, psychiatrists, and medical residents. Male OB/Gyn’s can be a kick and I’ve never talked to a proctologist.
    This list could go on and on and on. However:

  • Listening to a peon drug-rep vs your local pharmacist is really upsetting, seriously. Its like thinking the only way to make salsa is via some new rocket chef gizmo on paid-sponsoring television
  • Treating us like bean-counters is also upsetting. There is a reason why we went to college and have degrees (sometimes even doctorates). Sometimes we feel like we are your pharmacology book sitting there on your shelf (collecting dust) holding something up.
  • We are as much “wanna be doctors” as you are “wanna be pharmacists”. Anyone can work on a car, but a mechanic is going to get the job done right the first time.
    So if I offended any doctors out there reading, my apologies. This blog is like going out for beers after work with your colleagues and bitching about what happened. I had a really angry response to a nasty comment (from a doctor) I received, but I think i’ll just sit on it for now.
    Now approve my damn refill requests! Its been a week! 🙂

  • FDA, What the Hell?

    Quinine. Yes, quinine.
    Turns out that the FDA is going to pull this oldie-but-goodie off of the market. Why you say?

  • No published studies to show that it works for leg cramps
  • There have been deaths related with its use.
    Uh, hello? Quinine has been out since God was a boy. Its only been dispensed bazillions and bazillions of times to people for nocturnal leg cramps. Obviously it works. Do you see any published studies for aspirin? Of course not, but FDA wont get its panties in a bunch about that.
    Deaths with quinine. Since 1969 guess how many deaths there were. 100? No, 1000? No, a billion? No! 93. Thats right, 93 people have died due to quinine since 1969. Hell, pull tylenol off of the market if you’re afraid of killing people. Aspirin has caused more deaths in its lifetime than any drug to this date. But no, the FDA needs to justify its existence by targeting quinine
    FDA, if you’re reading this, get a fucking clue and quit getting sucked off by the drug companies. We’re onto your little scheme. It’ll go like this:
    1. FDA pulls quinine due to lack of evidence of it working for leg cramps
    2. Drug company X does some half-assed study showing it works better than placebo
    3. FDA approves NewQuinine.
    4. Drug company X charges $10/tablet vs $0.04/capsule for the old generic
    5. Profit!
    6. America grabs their ankles.
    The FDA is ran by a bunch of old doctors who haven’t practiced medicine for 30 years. They have no clue what the hell is going on and approves medications to whoever will give them a dollar and a reach-around. They’ll sit on tons of generics in the pipeline to be approved, but will pull a drug that has been around forever and is still in common use. They need to wake the fuck up. Yes, drugs have side effects. Yes, if you take 100 of drug X you will die. Doesnt mean pulling it off the market will fix it.
    Or maybe we just need to slaughter all the lawyers. Hmmmmmmm….