Category Archives: Drug Trivia and Rants

Soma, the Magical Drug

So I saw DrugNazi’s little soma display window pictures here
So I have to jump on the bandwagon for those non-pharmacists. If you’re a pharmacist, just ignore this explinations.
As DrugNazi said, Soma is a non-controlled muscle relaxant used along with Vicodin or Valium to help increase their effects. Abused to all hell. In fact, the crackheads want the ones manufacturered by Watson Labratories (Formerly by Danbury) because it has “DAN” written on the tablet. So when they call and ask for a price for soma, they ask how much the “DANs” call. Sorta like how quaaludes were just called ‘ludes. Street lingo, ya dig?
Ironically, Soma was created in fiction long long before some drug company decided to press it into tablets and sell it to addicts. It was in Aldous Huxley’s Brave New World as a “Miracle Drug”. Hmmm.. thats a little too close to be scary.
So when I found this out many years ago, I found a page of quotes from the book about Soma. I printed it out, and hung it on my wall for shits and giggles. The page is still up, so without further adeu (pharmacists, dont shit yourself from laughing, this shit is from a long time before soma came out):


Soma in Aldous Huxley’s
Brave New World
http://www.huxley.net/soma/somaquote.html
“All the advantages of Christianity and alcohol; none of their defects.”


“..there is always soma, delicious soma, half a gramme for a half-holiday, a gramme for a week-end, two grammes for a trip to the gorgeous East, three for a dark eternity on the moon…”


“Benito was notoriously good-natured. People said of him that he could have got through life without ever touching soma. The malice and bad tempers from which other people had to take holidays never afflicted him. Reality for Benito was always sunny.”


“you do look glum! What you need is a gramme of soma.”


“Soma was served with the coffee. Lenina took two half-gramme tablets and Henry three.”


“the warm, the richly coloured, the infinitely friendly world of soma-holiday. How kind, how good-looking, how delightfully amusing every one was! ”


“Swallowing half an hour before closing time, that second dose of soma had raised a quite impenetrable wall between the actual universe and their minds.”


“The service had begun. The dedicated soma tablets were placed in the centre of the table. The loving cup of strawberry ice-cream soma was passed from hand to hand and, with the formula, “I drink to my annihilation,” twelve times quaffed.”


“By this time the soma had begun to work. Eyes shone, cheeks were flushed, the inner light of universal benevolence broke out on every face in happy, friendly smiles. Even Bernard felt himself a little melted.”


“I don’t understand anything,” she said with decision, determined to preserve her incomprehension intact. “Nothing. Least of all,” she continued in another tone “why you don’t take soma when you have these dreadful ideas of yours. You’d forget all about them. And instead of feeling miserable, you’d be jolly. So jolly,”


“Was and will make me ill,
I take a gram and only am.”


“When the Warden started booming, she had inconspicuously swallowed half a gramme of soma, with the result that she could now sit, serenely not listening, thinking of nothing at all, but with her large blue eyes fixed on the Warden’s face in an expression of rapt attention.”


“Bernard also laughed; after two grammes of soma the joke seemed, for some reason, good. Laughed and then, almost immediately, dropped off to sleep,…”


“”But it’s terrible,” Lenina whispered. “It’s awful. We ought not to have come here.” She felt in her pocket for her soma – only to discover that, by some unprecedented oversight, she had left the bottle down at the rest-house. Bernard’s pockets were also empty.”
Lenina was left to face the horrors of Malpais unaided.”


“Lenina was still sobbing. “Too awful,” she kept repeating, and all Bernard’s consolations were in vain. “Too awful! That blood!” She shuddered. “Oh, I wish I had my soma.” ”


“A gramme is better than a damn,” said Lenina mechanically from behind her hands. “I wish I had my soma!” ”


“Her tears began to flow again. “I suppose John told you. What I had to suffer – and not a gramme of soma to be had. Only a drink of mescal every now and then, when Popé used to bring it.””


“As soon as they got back to the rest-house, she swallowed six half-gramme tablets of soma, lay down on her bed, and within ten minutes had embarked for lunar eternity. It would be eighteen hours at the least before she was in time again.”


“”By his heretical views on sport and soma, by the scandalous unorthodoxy of his sex-life, by his refusal to obey the teachings of Our Ford and behave out of office hours, ‘even as a little infant,'” (here the Director made the sign of the T), “he has proved himself an enemy of Society, a subverter, ladies and gentlemen, of all Order and Stability, a conspirator against Civilization itself. For this reason I propose to dismiss him, to dismiss him with ignominy from the post he has held in this Centre…””


“So the best people were quite determined not to see Linda. And Linda, for her part, had no desire to see them. The return to civilization was for her the return to soma, was the possibility of lying in bed and taking holiday after holiday, without ever having to come back to a headache or a fit of vomiting, without ever being made to feel as you always felt after peyotl, as though you’d done something so shamefully anti-social that you could never hold up your head again. Soma played none of these unpleasant tricks. The holiday it gave was perfect and, if the morning after was disagreeable, it was so, not intrinsically, but only by comparison with the joys of the holiday. The remedy was to make the holiday continuous. Greedily she clamoured for ever larger, ever more frequent doses. Dr. Shaw at first demurred; then let her have what she wanted. She took as much as twenty grammes a day.
“Which will finish her off in a month or two,” the doctor confided to Bernard. “One day the respiratory centre will be paralyzed. No more breathing. Finished. And a good thing too. If we could rejuvenate, of course it would be different. But we can’t.”


“Surprisingly, as every one thought (for on soma-holiday Linda was most conveniently out of the way), John raised objections.
“But aren’t you shortening her life by giving her so much?”
“In one sense, yes,” Dr. Shaw admitted. “But in another we’re actually lengthening it.” The young man stared, uncomprehending. “Soma may make you lose a few years in time,” the doctor went on. “But think of the enormous, immeasurable durations it can give you out of time. Every soma-holiday is a bit of what our ancestors used to call eternity.” ”


“In the end John was forced to give in. Linda got her soma. Thenceforward she remained in her little room on the thirty-seventh floor of Bernard’s apartment house, in bed, with the radio and television always on, and the patchouli tap just dripping, and the soma tablets within reach of her hand – there she remained; and yet wasn’t there at all, was all the time away, infinitely far away, on holiday; on holiday in some other world, where the music of the radio was a labyrinth of sonorous colours, a sliding, palpitating labyrinth, that led (by what beautifully inevitable windings) to a bright centre of absolute conviction; where the dancing images of the television box were the performers in some indescribably delicious all-singing feely; where the dripping patchouli was more than scent – was the sun, was a million saxophones, was Popé making love, only much more so, incomparably more, and without end.”


“”The Savage,” wrote Bernard, “refuses to take soma, and seems much distressed because of the woman Linda, his m—, remains permanently on holiday. It is worthy of note that, in spite of his m—‘s senility and the extreme repulsiveness of her appearance, the Savage frequently goes to see her and appears to be much attached to her – an interesting example of the way in which early conditioning can be made to modify and even run counter to natural impulses (in this case, the impulse to recoil from an unpleasant object).”


“Helmholtz and the Savage took to one another at once. So cordially indeed that Bernard felt a sharp pang of jealousy. In all these weeks he had never come to so close an intimacy with the Savage as Helmholtz immediately achieved. Watching them, listening to their talk, he found himself sometimes resentfully wishing that he had never brought them together. He was ashamed of his jealousy and alternately made efforts of will and took soma to keep himself from feeling it. But the efforts were not very successful; and between the soma-holidays there were, of necessity, intervals. The odious sentiment kept on returning.”


“When one has leant forward, nearer and nearer, with parted lips-only to find oneself, quite suddenly, as a clumsy oaf scrambles to his feet, leaning towards nothing at all-well, there is a reason, even with half a gramme of soma circulating in one’s blood-stream, a genuine reason for annoyance.”


“What’s in those” (remembering The Merchant of Venice) “those caskets?” the Savage enquired when Bernard had rejoined him.
“The day’s soma ration,” Bernard answered rather indistinctly; for he was masticating a piece of Benito Hoover’s chewing-gum. “They get it after their work’s over. Four half-gramme tablets. Six on Saturdays.”


”Hug me till you drug me, honey;
Kiss me till I’m in a coma;
Hug me, honey, snuggly bunny;
Love’s as good as soma.”


“Drying her eyes, Lenina walked across the roof to the lift. On her way down to the twenty-seventh floor she pulled out her soma bottle. One gramme, she decided, would not be enough; hers had been more than a one-gramme affliction. But if she took two grammes, she ran the risk of not waking up in time to-morrow morning. She compromised and, into her cupped left palm, shook out three half-gramme tablets.”


“Soma distribution!” shouted a loud voice. “In good order, please. Hurry up there.”


“”No shoving there now!” shouted the Deputy Sub-Bursar in a fury. He slammed down he lid of his cash-box. “I shall stop the distribution unless I have good behaviour.”
The Deltas muttered, jostled one another a little, and then were still. The threat had been effective. Deprivation of soma-appalling thought!
“That’s better,” said the young man, and reopened his cash-box. ”


“”Don’t you want to be free and men? Don’t you even understand what manhood and freedom are?” Rage was making him fluent; the words came easily, in a rush. “Don’t you?” he repeated, but got no answer to his question. “Very well then,” he went on grimly. “I’ll teach you; I’ll make you be free whether you want to or not.” And pushing open a window that looked on to the inner court of the Hospital, he began to throw the little pill-boxes of soma tablets in handfuls out into the area.”
For a moment the khaki mob was silent, petrified, at the spectacle of this wanton sacrilege, with amazement and horror.”


“Free, free!” the Savage shouted, and with one hand continued to throw the soma into the area while, with the other, he punched the indistinguishable faces of his assailants. “Free!” And suddenly there was Helmholtz at his side-“Good old Helmholtz!”-also punching-“Men at last!”-and in the interval also throwing the poison out by handfuls through the open window. “Yes, men! men!” and there was no more poison left. He picked up the cash-box and showed them its black emptiness. “You’re free!”


“The policemen pushed him out of the way and got on with their work. Three men with spraying machines buckled to their shoulders pumped thick clouds of soma vapour into the air.”


“Two minutes later the Voice and the soma vapour had produced their effect. In tears, the Deltas were kissing and hugging one another-half a dozen twins at a time in a comprehensive embrace. Even Helmholtz and the Savage were almost crying. A fresh supply of pill-boxes was brought in from the Bursary; a new distribution was hastily made and, to the sound of the Voice’s richly affectionate, baritone valedictions, the twins dispersed, blubbering as though their hearts would break. “Good-bye, my dearest, dearest friends, Ford keep you! Good-bye, my dearest, dearest friends, Ford keep you. Good-bye my dearest, dearest …”


“”Because our world is not the same as Othello’s world. You can’t make flivvers without steel-and you can’t make tragedies without social instability. The world’s stable now. People are happy; they get what they want, and they never want what they can’t get. They’re well off; they’re safe; they’re never ill; they’re not afraid of death; they’re blissfully ignorant of passion and old age; they’re plagued with no mothers or fathers; they’ve got no wives, or children, or lovers to feel strongly about; they’re so conditioned that they practically can’t help behaving as they ought to behave. And if anything should go wrong, there’s soma. Which you go and chuck out of the window in the name of liberty, Mr. Savage. Liberty!” He laughed. “Expecting Deltas to know what liberty is! And now expecting them to understand Othello! My good boy!””


“Bring three men,” he ordered, “and take Mr. Marx into a bedroom. Give him a good soma vaporization and then put him to bed and leave him.”
The fourth secretary went out and returned with three green-uniformed twin footmen. Still shouting and sobbing. Bernard was carried out. ”


“And if ever, by some unlucky chance, anything unpleasant should somehow happen, why, there’s always soma to give you a holiday from the facts. And there’s always soma to calm your anger, to reconcile you to your enemies, to make you patient and long-suffering. In the past you could only accomplish these things by making a great effort and after years of hard moral training. Now, you swallow two or three half-gramme tablets, and there you are. Anybody can be virtuous now. You can carry at least half your mortality about in a bottle. Christianity without tears-that’s what soma is.”


“Benighted fool!” shouted the man from The Fordian Science Monitor, “why don’t you take soma?”
“Get away!” The Savage shook his fist.
The other retreated a few steps then turned round again. “Evil’s an unreality if you take a couple of grammes.”
“Kohakwa iyathtokyai!” The tone was menacingly derisive.
“Pain’s a delusion.”
“Oh, is it?” said the Savage and, picking up a thick hazel switch, strode forward.
The man from The Fordian Science Monitor made a dash for his helicopter.”


“It was after midnight when the last of the helicopters took its flight. Stupefied by soma, and exhausted by a long-drawn frenzy of sensuality, the Savage lay sleeping in the heather. The sun was already high when he awoke. He lay for a moment, blinking in owlish incomprehension at the light; then suddenly remembered-everything.
“Oh, my God, my God!” He covered his eyes with his hand.”


PS: If you try to post any comments regarding soma, my server might yell at you and punch you in the face. Like me, its tired of getting hounded by people wanting to sell/get soma. So you can find creative ways around that.. 🙂

Yay! More Hate Mail!


Apparently you have came across neuropathy .. did you ever think that many/most of these people on all these meds & caid was because their pain has developed to such an intensity that they can no longer work and end up on Medicare disability and Medicaid.
Those people are standing at your front door mostly likely because their doc is under-dosing them and they are either out and/or going into or suffering from withdrawal & pain .. not from ADDICTION but DEPENDENCY..
The quack doc my mother-in-laws goes to just told her not to call her pain meds refills in UNTIL she takes the LAST PILL.. as we all know .. docs don’t take refills on nights & weekends
It would be nice .. if everyone was on the same page

I used to work in pain management dealing with patients who are on a whole boatload of opioids just so their QoL would be somewhat normal (3 x 100 mcg fentanyl patches, or 2-3 grams of Morphine SR/day). I dealt with diabetics with neuropathy to terminal cancer (hospice). I can tell when someones in pain and when someone is blowing smoke up my ass.
When someone laughs, bullshits, and walks normally from their car to the parking lot (from which I have a complete and plain view of) to be instantly be struck by the pain machine and limp, moan, cry once they hit the pharmacy doors, i doubt they are truly in pain. Anything that comes out of their mouth is bullshit. To make things worse, they limp out of your store to walk normally and bullshit with people in the parking lot just fine. Wonderful.
When you see people on vicodin, valium, and soma (three times a day on each) filled once a month for the last year (from your store). Then see they are getting it from 3 other stores (via 3 other doctors) per month when you request the Bureau of Narcotic Enforcement CURES data you begin to wonder how much pain they are in.
Plus, what doctor writes for Vicodin or any short acting opioid for truly chronic pain (including neuropathy), thats stupid and silly. Adding Soma and Valium? Why not Baclofen or Flexeril? Oh, because the patient is requesting Soma because it works ‘better’ even though they have never tried any other one. Somethings not adding up here.
The real chronic pain patients (for those at home) are the ones who are on MS Contin, Oxycontin, Methadone, or Fentanyl Patches. Plus add on some sort of NSAID, Neurontin, and a short acting opioid (usually Norco) for breakthrough pain. If they are tuned perfectly, the breakthrough med would be hardly used at all. They are compliant, will call you (and the doctor) to let you know mid-month that stuff needs to be adjusted, and will not sit and yell at you on Friday night after everyone has gone home that they are out of their pain meds (when they should of known a few days ago they were getting low). They are responsible patients who treat their pain as seriously as anyone with hypertension or diabetes. The doctors who prescribe them are responsible, willing to take input (you talk to the patients a lot more than they do), and just generally a pleasure to work with.
But like all laws we have, the bad apples just ruin it for the good apples. People want to error on whats not going to jeopardize their license, not whats best for the patient.. So yes, everyone is on the same page. If you want to keep your license, and /not/ become a ‘Soft Touch’ pharmacy thats a big red dot on the DEA’s (and every addict in town’s) list, you have to be aware and not just fill everything assuming everyone is honest and legit. I mean seriously, how many excuses can you take on why the patient needs their narcs early before you stop and think that maybe they are lying to you.

Angryness and Me

So i’ve been doing some self thinking as to why I get angry at work. I mean it cant be normal for me to get really upset when I waste my time filling someones Rx (that they bring the empty bottle) not realizing that he wanted some other Rx filled (that wasnt the empty bottle).
I mean would any ‘normal’ person get pissed off when you’re on hold for 30 min before the patient says “oh, do you need this insurance card?” after you ask them 100 times if they have any insurance cards.
I mean a 14 year old getting prenatal vitamins shouldnt get your blood boiling. I mean what if it is their second kid? Thats no biggie right?
Getting yelled at because the doctor wont okay soma early shouldn’t bug me too much, but it does. I think you get the point.
I think I get frustrated because I dont think of myself as ‘better’ than anyone around me. Just because I physically stand a half foot above you, doesnt make me any better than the person who cleans the toliets, or the person who bags my groceries, or the kind fellow who pumps my gas. These people have jobs just like me, pay taxes just like me, and drag their asses to work just like me. Im sure they have a unique skill that they are awesome at. Mine’s pharmacy, and happens to be what I do for a living. Just because im a pharmacist doesnt make me better than you, its just what I do for a living.
But then I see stupidity in its rawest unearth form. Stupidity so intense that if it wasn’t for the kind state upon which I live wiping these people’s asses, they would be unable to live. I cant wrap my brain around how a person could be so utterly useless and stupid.
I dont expect you to understand how your medication works. Thats not your job, thats mine. I dont expect you to know what the proper dose is, or if your doctor is trying to kill you or not, thats also my job. I do have some sort of expectations that when the bottle says “One Tablet Daily” you will put one tablet in your mouth a day, and swallow. For some people, this mental feat rivals quantum physics.
How hard is it to follow simple directions? Even a dog knows not to shit in on its own bed, and can follow simple commands. I absolutely hate to talk down to people. It makes me feel like an idiot and makes the other person feel like a child. However im forced to do that on a daily basis. Thats the language they understand. Do I really need to tell you to remove the foil off of a suppository before you shove it up your ass? When a bottle says “SHAKE WELL” do you really need to ask me if you are supposed to shake it? That 3/4 is three-quarters of a teaspoon, not 3 to 4 teaspoons. That 1 mL (which is clearly marked on the dropper) is NOT the same as 5 mL.
Sometimes I feel like the patients are just screwing with me. You know, asking me stupid questions to be funny. Then I realize that they arent being funny, they seriously dont have the mental capacity to read and follow simple instructions printed out in plain english (which is the only language they speak). It boggles my mind so much I want to walk down there and shake them saying “WHATS WRONG WITH YOU! WHY DONT YOU UNDERSTAND!”. Seriously kids, cribs + lead paint = not good. Paint chips are not food, and not your friend.
I already have a very limited patience for people, however I expect people to not know how the human body works, or what that rash is growing under their boob. Those people I will spend as much time as I can explaining things in a language they can understand. However simple instructions like ‘twice daily’ or ‘leave this nix in your hair for 8 to 12 hours then rinse out’ should be universally understood no matter what education level you have.
So all in all, my ethics/tact/respect/how i was raised say “person is equal, must treat as equal” on one side, but then the patient is a complete and utter moron. So that makes my brain go into overload thinking “if person is equal, and person is idiot, then I am idiot! I am not idiot!”. Its not my intention to look down upon people (forget for a second what you read here) but maybe I might have to learn to.

Drug Reps, part Duex

** I got this information sorta second hand, so it might be wrong **
(But if it is wrong, who cares! Its about dumbass drug reps!)
So I heard today via the pharmacy grapevine about how this Rep for a reputable blood glucose monitoring machine gave another pharmacist both barrels. You can probably guess from the story below who this person works for and exactly what i’m talking about.
“But why!” you may ask. “Why would a drug rep give a pharmacist both barrels about something!”
Its because they were primarily dispensing a competitors machine, thats why. Heres the backstory.
STORY TIME! STORY TIME! Yaaaaaaaaaaaaaaaaaaaaaaaay!
It was a typical day in pharmacyland. The soma was flowing, valium were chirping (uhh, more like sleeping), and the patients demanded their Vicodin ES a week early because they “lost them”.
You see, this blood glucose monitor started out as a very small company. The reps were very nice, and stopped by at a somewhat regular basis to see how we were doing, etc. They would give us free machines, and pamphets, and would be in contact with our local wholesaler to make sure strip supplies were up to specs. I had his work and cell number, and whenever someone had a problem with a machine he would make sure it was right. He even paid for a huge window painting in our front window as advertisement to bring people into the store. In fact, I didnt know if he was just really really nice, or wanted to get into my angry pharmacist pants. Disturbing, but hey, cant blame him!
Anyhoo, Grade A guy from a grade A company. Small company, good service.
Then a larger company bought this small company. This company wanted to get in on the big boom of blood glucose machine. Obviously this company wasn’t happy with making products such as Depakote (heh) and making all their pills smell like jordan almonds with their tasty candy coating. This company was greedy because they already had their own brand of meter.
So our friendly rep came in, and said that he wasnt going to be our friendly rep any longer because his company was being bought out. I said goodbye to the friendly rep, and wished him well. I was sad, because I liked this small company’s machines, and they had this nifty deal called a “Value Pack” where a free machine was packaged in with 100 test strips! No more diddlying around trying to get the machine /and/ the strips to go through some douches insurance. You can just run through the 100 strips and give them the meter! I was also sad because I knew that it was a big mistake giving a ton of these machines out, and I just dropped the proverbial soap in front of this big company. My pooter was right there plum ripe for the screwing I was about to receive.
Time passes, and things don’t seem that bad. We can still get the “Value Packs”, and although we don’t have the friendly rep bringing is donuts and the foreign concept of ‘personal service’ we haven’t got screwed over (yet). We can get the strips, and our diabetic patients are happy.
(for some reason I switch into 3rd person here, i have no idea why)
Then tragity strikes. The ‘Value Packs’ get harder and harder to get. “Oh no!” said the angry pharmacist (actually it was more like “aww fuck!”) “I cant get the value packs! What if a new diabetic needs a new machine! I cant put them through calling the damn 800 number, talking with a drone and having one shipped out for me to get zero profit on but have to show how to use!”
The angry pharmacist was.. well.. angry (duh). Although he was angry, he had a plan. “I shall continue to support the patients who have this machine, but I shall find a /new/ machine to give out to the new diabetic patients!!!” and so he did. A nice rep from a small division of a larger nicer company (herein referred to as ‘small company’) came bearing gifts, a whole big box of free machines! “Hooray!” said the angry pharmacist “Where am I going to find the space to store this big box full of free machines!!”. The rep was nice, very nice, and didn’t dress like a damn skank like some other drug reps that I see once in a blue moon. Although they werent ‘value packs’, she was from a small company, and free machines were just a phone call and a UPS package away.
So fast forward a few months to the present. It turns out that the big company didn’t like us pharmacies dispensing a competitors product so they yelled at us bad pharmacists. “BAD PHARMACIST” said the angry big-company drug rep. “Here are some coupons so you can give away OUR machines for free too! Because we’re a big company and we’re SMRT like that”. The angry pharmacist was not amused. He didnt want to have to add /another/ insurance to a patients record to make 5 bucks. He was lazy, and lazy means grabbing a free machine and not having to turn it into an Rx.
Then the angry pharmacist makes another discovery. “These strips are 2/3’s the cost of the big company strips! Huzzah! Now cash paying customers wont have to take out a second mortgage to afford test strips! Free machine s, low cost test strips, AND personal service from the company? I must be in angry pharmacist heaven!” the big bad drug company didnt like that, and yelled at the poor pharmacists “BAD PHARMACIST USE OUR STRIPS THEY ARE BETTER. HAW HAW HAW”.
The End (actually I need to find out how this resolves tomorrow).
And thats pretty much it. Yeah, anticlimactic i know. However after reading this story back I cant stop laughing. Remember! This is second hand information! Well, except the big bad company, they just suck ass for stopping the value packs, thats first hand information. Actually everything is first hand except for the actual yelling by the drug rep.

Ambigious drugs, fortune telling, and doctors who dont know shit

How many of you have been in this position:
You get an Rx for a medication; say, Effexor. Doctor has a strength; say 37.5. Doctor wrote directions; say once a day.
Now if you read this literally, you would dispense Effexor (standard release) once a day. However the sig suggests the extended release (XR) that is once a day and not the regular release that is usually given more than once a day (but sometimes given once a day as well). Do you dispense regular or XR? Does the doctor even know it comes in a regular and and XR?
Now you would think (common sense here), that the drug company would get their collective head out of their asses to make the XR product have a different miligram strength as to avoid this problem. You know, so if the doctor forgets the XR part on the Rx, you can tell its the XR by the strength.
Of course not. That makes sense, and if it makes sense (and totally fucks over the pharmacist), then its not worth doing. They need to do the paper work for the new formulation, why not change the miligram strength by 0.5? Why not have it be like percodet/percodan and have 0.45 mg of oxycodone salt A, 0.923423 mg of oxycodone salt B, and (5mg – (Salt A and Salt B)) of oxycodone salt C (to really confuse the fuck out of us).

New Sudafed Laws.

As of 9/30/06 – a new sudafed law took into effect.
Every single product containing pseudoephedrine (PSE) has to be either in a locked cabinet or behind the counter. Also all sales of PSE containing products need to be logged in a book with a drivers license number, address, reason for taking it (wtf?) and signature. This is to “Curb the production of Methamphetamine”. The daily limit is 3.6 grams of sudafed and the monthly limit is 9 grams of sudafed.
This is so fucking outrageous and stupid it makes my head spin. -All- PSE containing products. That means infant cough/cold drops need to be locked up. Dimatapp needs to be locked up. Everything! Retarded! Is some crackhead going to cook 60 gallons of pediacare drops to make meth? Fuck no! I can see the stock bottles of 100 PSE 60mg, but childrens cold preps?
Who are they fooling anyways? Do they think that this is magically going to stop the production of meth? Dont they realize that the shit is being trucked in by the tons from Mexico? That its perfectly possible for a person to drive across the boarder, pick up like eleventybillion pounds of this shit, and just truck right on back in?
But no, just like guns and other things that are cool, the law abiding citizens have to pay for all the fuckups doing. I predict that this will have no effect on the production of meth. Im even willing to put money on it.
What gets me, is that they have to sign a log book, and their daily limit is 3.6 grams. What stops them from just going across the street to Walgreens and picking up another 3.6 grams; then to Longs, 3.6 grams; Rite Aid? Yup! 3.6 grams! Who cares if they sign the log book. The DEA agent is going to look at it and say “Yup, this dude we caught went to 10 different pharmacies in the same day and bought sudafed”. No fucking shit asshole! Will the pharmacies get in trouble? No, because we complied with the 3.6 grams/day law. So really, whats the point of this stupid shit anyways? Much like cocaine, C2 narcotics, and the “War on Drugs” bullshit, this whole program looks good on paper but will cost us more money and time than building a huge moat (with sharks) between us and Mexico.
People need to start using some common sense and stop selling sudafed to the fucking tweaker at 3am rather than punish the rest of us. I know what will curb the production of meth, public executions for the people who make it.

Stupidity, Doctors, and Drug Reps

I know I havent updated in a bit, but to be honest I havent been really angry about anything new and exciting to rant about! I know you would all /hate/ to see me rehash something over and over (*ahem*non-english-speakers*ahem*) but never fear, stupidty came to the rescue!
All pharmacists have been in this situation before:
You’re working along; pissed off at the smelly twat in front of you who wants her soma filled 3 weeks early, when in walks this nicely dressed guy/gal in a suit and tie (or low cut dress and skirt) and just waltz’ right up to the counter.
Your thoughts?

  • Shit! State Board! Make a few techs “clerk typists” and put your name badges on! HOLY SHIT HIDE THE OUTDATES!
  • Auditors! God dammit!
  • Another /FUCKING/ drug rep to waste my time.
    I rate drug reps about one step lower than used car salesmen. At least used car salesmen know they dont know shit. Drug reps think they know everything under the sun about whatever crap they are throwing back up at you. Its downright silly sometimes. I know some have “degrees” and that crap, but honestly, a drug rep compared to a pharmacist in the therapeutic and pharmacology department.
    The worse part is that the doctors just gobble this shit up like no tomorrow. Do doctors have rocks in their heads? Oh wait, we all know the answer to this. Why will a doctor listen to some two-bit twat with a low cut shirt about some drug she has /no/ idea how it works or who covers it and not your local neighborhood pharmacist who deals with this shit day in an day out. Oh wait, we all know the answer to this one too. I need to grow some tits or something.
    Doctors are idiots. They will use a product for 20 years without any complaints, but will switch at the drop of a hat when some big tittied blonde comes waltzing in with her porno high heels on. They say “ooooh, but the studies show this one is better.. ooooooooooh”. Look who funded the study you dumbshit, of course its going to say its better when the drug company pushing the shit is footing the bill for the study! When do you see a published paper about a drug where the funding company’s product rates lower than the ‘gold standard’. Wait…. Ultracet, my bad again.
    Now dont get me wrong. This only applies to the /new/ drug reps. We had one in the other day, threw some nice pens on the counter and proceeded to bullshit with the two other pharmacists who have known him for 30 years. Not once did he want to talk to me about a ‘study’ that shows ‘my product’ to be superior to ‘their product’. He asked how we’re doing, if we needed anything, and off he went. Excellent.
    The new ones however will throw a fistful of studies in your face showing how their product is “better”. Who reads these fucking studies? Its like reading Romeo and Juliet and being surprised that they die at the end! Or watching a Keanu Reeves movie and expecting some good acting! Or reading this blog and expecting me to be happy! We all know they arent going to give you studies that shows their product preforming worse than the current therapies, so why bother reading them.
    The best is this new product, I think its called “Proquin XR” or some bullshit like that. Its basically Cipro in a once daily treatment for UTI. Big warnings in the magazines: “THERE IS NO SUBSTITUTION FOR THIS PRODUCT”. My ass their isnt. One phone call saying that this $6/pill magic wonder isnt covered and its getting substuted for a 10 day run of generic cipro for $9 out the door. Drug companies can blow me with their “NO SUB” bullshit. I’m going to fucking sub it regardless what your paper says (with doctor or whatever numbskull will say yes and give me their name’s okay of course).
    I hate drug reps so much that when I go to their verbal-masturbation sessions (ie: Free Dinners), I order the most expensive thing on the menu even if I dont like it. Hey, i’m bitter, but i’m not an idiot. A free dinner is a free dinner, and i’ll sleep through a talk to get a $75/plate dinner that I would never have by myself.
    Why do drug reps even come into my work. As if i’m going to do what they say. Thats about as smart as refilling a vicodin prescription because the patient said “I talked with the doctor, and he said it was okay to fill”.. “dur dee dur, okay! heres your refill.. duuuuuuhhhhhhhhhhhhhh”….
    The best are the test-machine reps. They come in with their little name-tag, and their little briefcase with their little meters in them. They want me to sit down so they can show me how the meters work (as if I cant figure it out on my own, yanno how different all 10000 meters on the market are). Then they explain to me how wonderful theirs is compared with all the other ones, blah blah blah. Then they give me some post-its (which I like), and those cheap plastic pens. They act all shocked and confused when I ask for the “doctors pens”. You all know, the really heavy ones that come in a nice velvet sleeve. The ones they dont give to us piddly pharmacist. Some just lie and say they dont have any, upon which I ask for the one they are using. Others pony up and walk out to the car to either retrieve one pen, or just get in and drive off leaving me high and dry. I think i’d warm up to drug reps a bit more if they said “oh, if you use this product, i’ll go wash your car!” or “I’ll give you a backrub if you use product X”. “Need the floor swept? Think of Diovan!”
    Doctors need to start prescribing based upon good judgement and their pharmacological training (haaaaaa haaaa!) and not based upon what some dirty multi-kerzillion dollar company tells them to prescribe.

  • Prenatal Vitamins & Bat Shit Crazyness

    There is one prescription that I know makes every pharmacist get a little bout of acid reflux in their lives:
    An Rx for some new funky-sounding prenatal vitamin with the big DAW-1 box checked. You know their insurance company isnt going to pay for it. Plus if they do, the’ll only cover a month supply so you’ll be stuck with the other 70 tablets making your prenatal section look like the warfarin /levoxyl sections (tons of bottles, all different strengths/colors).
    Are OB-Gyn’s retarded? Does sticking your fingers into vaginas for a living rot your brain? Do they realize that there is NO significant difference between the bazillion of prenatal vitamins out there, and the drug companies are just exploiting pregant womens drive to have a healthy baby? With the exception of Folic Acid, there is really no research showing that one brand of prenatal vitamin is better than any other one. Its such an inexact science (since women can take nothing and 99.9% of the time have a healthy baby) that it boarderlines voodoo!
    However to the uninformed: most prenatal vitamins have one of the following that make them “special”.

  • 1 mg of folic acid vs the 220mcg (or something) that the OTC ones have (folic acid has been shown to prevent spinal defects, so this one has some merit)
  • Some voodoo magical iron prep thats supposed to be gentle on the stomach of the pregnant woman who spends all day consuming dirt, pickles, and other wierd ass cravings.
  • Little hearts on the pills that make you feel all squishy as you pay $4/tablet
  • A bullshit name
  • 10000000% of your daily allowance of the B+C vitamins, knowing full well your body will just pee out 99.999% of it
  • 3.457mg difference in every other ingrediant thats present in all prenatal vitamins
    One woman claimed that she tried out 20 different brands of prenatal vitamins before she found one that “worked”. Now what the fuck is that supposed to mean? They all have the same shit in them! How can a prenatal vitamin “work” and more importantly, how can you tell its “working?” Does the fetus say “Yup, i feel it working better! Thanks mom! *thumbs up*”.
    Now dont make a mistake and bring up logic and reasoning in front of the poor pregnant gal. She’ll give you both barrels of hormone induced insanity all over your front counter in front of your entire staff (because its HER body and she knows exactly what the baby needs). Heaven forbid you’re a male, because you “dont know how it feels to be pregnant and taking inferior prenatal vitamins”. Reasoning with a pregnant woman is like reasoning with a turd, it just makes you feel stupid for wasting the time. Bad turd!
    OB-Gyn’s are partially to blame. The’ll write for whatever hot blonde walks in the front door with a low cut blouse and a bag full of samples. I can just see their fingers twiching wanting to give her a pelvic exam. They have been so brainwashed that they dont realize that an Rx for Folic Acid 1mg plus a super econo-size barrel of cheap generic centrum will do the exact same thing than StuartNatal.
    Just thinking about it gives me heartburn, must be those generic prenatal vitamins I take. 🙂

  • iPledge, the stupidest thing to come since Celgene’s STEPS!

    This last week I got my first experience with that new iPledge program.
    Let me backtrack.
    iPledge is this new system that came out to manage the dispensing of Accutane. You know, the anti-acne medication that if you take it while pregnant causes huge birth defects. So to make themselves feel better at night, they created this stupid program that basically accounts for every accutane prescription thats written. The outcome is that whenever I get an accutane Rx, I need to call the iPledge program (or go online via their broken ass website) to tell them what patent im giving the drug to, how much, and for what days supply.
    I know this whole bullshit is for liability reasons. Dispite the fact that every damn pill has a big DO NOT GET PREGNANT on it, and tons of warnings all over the packaging, somehow people are stupid enough to get pregnant while on Accutane. To them, I say “tough shit, you’re a dumbass. If you sue because of your fucked up baby, its your own fucking fault”.
    Are we next going to be putting “DO NOT DRINK” stickers all over bleach? Are people sueing Clorox because their daughter drank bleach? What about alcohol? Tons of children are fucked up because of alcohol use while pregnant, but you dont see tons of DO NOT GET PREGNANT stickers all over bottles of King Cobra nor a mandatory reporting everytime a store sells booze!
    The iPledge program is stupid. Very stupid. In fact, my first Rx dispensed with iPledge resulted in me calling their asses 4 times and the patient twice to get everything settled. I asked the poor girl who worked there if pharmacists were pissed off at the hoops we had to jump through, and they said “Well, sorta.” No fucking shit! Come on people! Personal accountability! If you decide to get pregnant while on this, even though it says DO NOT GET PREGNANT with little crossed out pregnant woman pictures /everywhere/ then its your own fucking fault! Get it? Your own fucking fault! No suing! No bullshit! Close your fucking legs and take responsiblity for your own mistake!!! The fact that they had to make this program to cover their own asses just shows you how pittiful and sue-happy our country has began. Its always someone elses fault!
    Wake up America! The high prices for medication are because of stupid people taking Rx medication (much like driving a car, has implied risks) and sueing the drug company over something thats totally out of their control! Furthermore, the greedy cock-sucking lawyers who take these cases should be publically hung by their scroatum for contributing to the problem!
    Hypothetically speaking, I dont have the balls to do this (yet):
    What if I dont call you. In fact, what if I completely blow your whole program off and just dispense the drug anyways? You cant stop me from getting the medication because unlike Celgene (with Thalomid) you are NOT the manufacturer and I do not order the product directly from you. Furthermore, you think my wholesaler is going to cut me off from this product when there are 10 different generic accutane manufacturers out there? I dont think so. Are you going to cut off my wholesaler when there are pharmacies that use the same wholesaler that are stupid enough to use the iPledge program? Are you going to sue me for something? Call the state board on me? Lets face it, you cant do jack and/or shit to me nor prevent me from dispensing this product. A quick call to the doctors office to confirm that the FEMALE patient is on birth control totally bypasses your whole program and legally absolves me from any liability. Of course i’m a good pharmacist and wouldnt do /anything/ like that to such a horribly designed program with a horribly designed website (https://www.ipledgeprogram.com/).
    Plus, to poke more holes in your already shitty program, how is this program going to prevent Betty Sue RottenCrotch from giving her slutty friends accutane under the table? Is iPledge going to detect that and magically send out the cooch-patrol to slam her legs shut? Lets face it, iPledge is just verbal masterbation that looks good on paper but really does nothing but waste mine and the doctors time.

    Avandia? Coreg? GSK get your head out of your ass.

    Who here in the audience has zero Avandia, AvandaMet or Coreg on their shelves?
    I for one, have zero. I might have a few partial bottles of Coreg, but zero Avandia. Now I remember back in the day when GSK had their shit together. Then one day, I get a notice in the mail that their manufacturing plant has been siezed (not shut down, but siezed) by the FDA. Whoops.
    Then the recalls came. Then Avandamet was never to be seen again. I really wish I knew what the fuck was going on behind the scenes. Did 1000 billion people suddenly become DM II and only Avandia would help them? Why were we having no problems getting it before, and now we get a bottle of 30 every other day if we are lucky. Maybe the GSK guys are out sucking Warrick’s cock because now albuterol MDI’s are like 9 bucks a pop!
    So I hope GSK is reading this as I write them a letter.
    Dear GSK,
    Please get your shit together so we can dispense Avandia to our patients. I dont care if you have to sell your soul to Satan to get this stuff on my shelves. Every day we convert 10 patients to Actos over your product. Again, get your shit together so we can dispense this to our patients.
    Love and Kisses,
    TheAngryPharmacist.