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Thursday, October 29, 2009
Welcome to Wal-Mart: Bargains to Die For!
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Walmart is not the first retailer to sell caskets and other funeral items online. The large discounter Costco already sells caskets online, and Overstock.com and Sam’s Club sell burial items, as well.
The caskets and other funeral items, come from McHenry, Ill based Star Legacy Funeral Network, Inc., which also supplies products to Costco.
Walmart casket prices range from $895 for the “Dad Remembered” and “Mom Remembered” steel caskets to $2,899 for the upscale Sienna Bronze Casket. Caskets at funeral homes can reach $5,000 or more.
Federal law requires funeral homes to accept outside caskets.
Walmart spokesman Ravi Jariwala said “Several online retailers offer this category on their sites. We are simply conducting a limited beta test to understand customer response.”
Thursday, October 22, 2009
Package Inserts: Do They Serve Their Function?
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Wednesday, October 21, 2009
Failure to Adopt Heart Failure Guidelines
An article in today's JAMA shows this to be the case with Heart Failure Guidelines. Watch this very short video released by JAMA. If you are captivated by this idea, then you may wish to read the entire paper: http://jama.ama-assn.org/cgi/reprint/302/15/1658
Also, here is an article by the Associated Press commenting on the published study :
http://www.google.com/hostednews/ap/article/ALeqM5gR2huSp8_aCl-iSQtwd11mCrUxDwD9BF1DU03
Tuesday, October 20, 2009
Can I Be Blunt With You?
In case you don't already know it, cigars can make a great matrix for drug delivery. Called Blunts (named after the type of cigar used), this dosage form is gaining wide acceptance, especially in places like California.
To learn more about this curious drug delivery system, watch the following short video:
Freedom of Speech: Isn't it wonderful?
The Correct Position for Defacation
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In case you care to know, there is a right way and a wrong way to go to the bathroom. The Figure at the left comes from a recent article published in BMJ.
I hope the apparatus under his feet is firmly planted on the ground. Otherwise, he would have a "loose stool."
For more information on this article you may want to click on the following link:
http://www.bmj.com/cgi/section_pdf/338/mar20_1/b831.pdf
And, no, I'm not kidding. This is a real article in the medical literature.
(Thanks go to David Angaran for bringing this landmark research to the attention of the faculty).
Friday, October 16, 2009
Does Giving Tylenol Reduce Efectiveness of Vaccines?
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Just when you thought you had figured out what to do about the flu vaccines, along comes a study that muddies the waters even more. It seems that a new study published in Lancet shows that giving acetaminophen after certain vaccines undermines the immunologic response that gives protection in the first place. Here are the details:
Acetaminophen May Weaken Effectiveness of Kids' Vaccines
Giving analgesic to prevent fever at shot time could be counterproductive, researchers say.
by Steven Reinberg HealthDay Reporter
THURSDAY, Oct. 15 (HealthDay News) -- Fever after a vaccination is a normal and essential part of building an immune response, and giving children acetaminophen -- best known in the U.S. as Tylenol -- after a shot could dampen that response, a new study finds. With some vaccines, transient fever means that a child's immune system is processing the immunization, providing them with the best protection, explained Dr. Robert T. Chen, a blood safety specialist at the U.S. Centers for Disease Control and Prevention.
Therefore, "unless your doctor specifically recommends it, do not administer fever-reducing medicines at the same time as vaccination to prevent your child from developing a fever," said Chen, who wrote an editorial accompanying a report in the Oct. 17 issue of The Lancet.
"It is still okay to use antipyretics [acetaminophen or ibuprofen] to treat a fever, but just not recommended to prevent fever," he added. "High fevers can be serious, especially in infants. It is important to work with your doctor to provide the best care for your child."
For the study, a research team led by Dr. Roman Prymula, from the University of Defence in Hradec Kralove, Czech Republic, did two studies, one when children received their first vaccination and another when they received their booster shot.
The vaccinations were routine for protection against pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio and rotavirus.
The 459 infants in the studies were randomly assigned to get acetaminophen every six to eight hours for 24 hours after vaccination or no acetaminophen.
Prymula's team found that fewer infants who received acetaminophen had a fever, but these babies also had significantly fewer antibodies against pneumococcal disease, Haemophilus influenzae type b, diphtheria and tetanus toxoids, and for one of the whooping cough antibodies compared with infants who did not get acetaminophen.
They believe the pain reliever's anti-inflammatory activity might trigger "interference" to healthy immune system antibody responses, explaining the weakened immunization.
"Unless there are specific reasons for controlling fever, for example, in a child with history of febrile convulsions, Tylenol and other fever reducers should not be routinely given along with immunizations," Chen said.
Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University School of Medicine in New York City, said that "the conclusion that Tylenol not only suppresses fever, but also decreases immune response is plausible. After all, what is an immune response? It's an inflammatory response."
Siegel agrees that acetaminophen should not be routinely given to infants to prevent fever after vaccination. "But, if the kid is sick, treat the sickness. If the kid is very sick, I would get the fever down," he said.
And what about the vaccine for the H1N1 flu? According to Siegel, "giving an infant Tylenol before an H1N1 flu vaccine shot may not be a problem, because the immune response to the vaccine has been so robust."
Here is a news pience from Fox News:
Police in Pa. Arrest Pothead--Literally!!
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The officer retrieved the bag from the man's forehead and asked, "Is this what you're looking for?", a police news release states.
The man, identified as Cesar Lopez, was charged with possession of a small amount of marijuana and possession of drug paraphernalia, police said. Police said it is not uncommon for people to store drugs inside the sweatband of baseball caps."
Wednesday, October 14, 2009
Behind Bars and Looking at a Real Long Stretch
One of the counts involved a death and they tell me that this carries a minimum mandatory sentence of 20 years. For him, that's a life sentence.
PENSACOLA — Destin physician Dr. David W. Webb was convicted Wednesday of 130 of the 131 charges federal agents brought against him in January. Amy Hunt, spokeswoman for the U.S. Attorney’s Office in Pensacola, confirmed that Webb’s conviction on one charge of a drug distribution makes him liable for four patient deaths. “It’s a relief. It’s well deserved. I’m glad to see justice was served,” said Deb Morrison, who said she went to authorities after the 2005 death of 21-year-old Anthony Moore, who she described as “my son’s best friend.” Webb, 67, and his wife, Bonnie Webb, were charged with 36 counts of health care fraud and 79 counts of illegally dispensing drugs. They also were charged with identity theft, conspiracy and the drug distribution charge involving the four deaths. Webb also was charged with making fraudulent health care benefit claims for patients another physician was seeing. Bonnie Webb, 57, who worked as her husband’s office manager, previously had pleaded guilty to the charges she faced. She is scheduled for sentencing Oct. 13. Hunt could not provide a sentencing date for David Webb. The Webbs operated the Doctors on Call clinic. Their arrests followed the seizure of 14,000 patient records. Prosecutors said at the time of the arrest that Webb had been prescribing drugs in high dosages and helping “doctor-shopping” patients abuse them. Webb was a longtime Destin physician who made house calls. Reports following his arrest said he had been under federal scrutiny for years. Federal agents had conducted an extensive review of Webb’s files in 2006, going through seven years’ worth of business and 100,000 office visits. As far back as 2005, Webb’s medical license was suspended for prescribing Viagra, Xenical and other drugs based solely on Internet order forms, according to a report. Prosecutors say he continued prescribing drugs during his suspension by using another doctor’s Drug Enforcement Agency registration number to conceal it.
Who Is This Pharmacist On the Cover of Florida Pharmacy Today?
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Here is her bio as it appears on the UF web site:
Dr. Karen Whalen joined the faculty as Clinical Associate Professor and Assistant Director of the St. Petersburg Campus in August 2008. Dr. Whalen received her Doctor of Pharmacy degree from the University of Florida. She then completed a Pharmacy Practice Residency at the Moses Cone Health System in Greensboro, North Carolina. Subsequently, she completed a Primary Care Residency at the James A. Haley Veterans’ Hospital in Tampa, Florida. Prior to joining the faculty at University of Florida, Dr. Whalen was an Associate Professor of Pharmacy Practice at Nova Southeastern University for twelve years. Dr. Whalen is a Board Certified Pharmacotherapy Specialist and a Certified Diabetes Educator. She maintains an active ambulatory care practice site with the Bay Pines VA Healthcare System. Dr. Whalen is an active member of the Florida Pharmacy Association, and currently serves as President of that organization.
I point this out for several reasons:
1. I am very proud that a fellow-faculty member has been entrusted to represent ALL pharmacists in the stae, regardless of practice venue,
2. She has found the time to serve despite the demands of her faculty position and family matters,
3. She is a UF grad and a former student of mine, and,
5. She is an extremely capable person who is a perfect role model for our pharmacists of the future.
You may also be interested to know that Dr. William Riffee, Professor and Dean of the College of Pharmacy, was elected "Speaker-elect " of the FPA.
As if that wasn't enough, Dr. Carol Motycka, Clinical Assistant Professor and Assistant Dean and Director of the Jacksonville Campus, was elected Chair of the Education Council of the Florida
Pharmacy Association (FPA) at the annual meeting of the FPA in St Augustine. Carol is also President-Elect of the Duval Co Pharmacy Association.
Oh, and lest I forget, it just so happens that the current president of the American Pharmacists Association is a Gator graduate and long time college supporter. Ed L. Hamilton, PharmD, FAPhA Director of Pharmacy at the Regency Medical Center in Winter Haven, Florida, was installed as President of the American Pharmacists Association (APHA) at the closing session of the association’s 157th Annual Meeting & Exposition in San Antonio, Texas, April 6, 2009.
There are Gator Pharmacists everywhere. Will you be the next one?
Tips From Doering's Drug Information Tool Box
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Tuesday, October 13, 2009
It's That Time of Year Again
Monday, October 12, 2009
A Touching Article Written by a 4PD Clerkship Student
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On The Shoulders of Giants
by Jena Koshaish, 4PD Student, St. Pete Campus
It’s 7:55 am and I’m checking a random vancomycin level from one of my patients drawn earlier this morning. The level is 25.5; darn, we over shot! But it’ll be ok because they have pneumonia and acute respiratory failure, we’ll need troughs around 20 to be aggressive. I’ll have to see them first and figure out what happened. I ask myself:
•Are they still on pressors (norepinephrine, vasopressin)?
•They came in septic, how is their renal function?
•What is their urine output?
•Did we draw cultures?
•Is this still empiric therapy or are we dealing with MRSA?
These are just a few of the questions I’ve been trained to ask in the intensive care unit at Lakeland Regional Medical Center.
Working the ICU is one of the most exciting places in the hospital. Usually patients are on several medications, titrated to keep the patient as hemodynamically stable and comfortable as possible while their body recovers from the trauma or illness. Pharmacists play a key role in the ICU by titrating pain and sedation medications, dosing antibiotics, optimizing blood glucose control, renally adjusting medications, monitoring therapeutic outcomes, choosing appropriate therapy for a given patient, ensuring that evidenced based medicine is practiced by referring to guidelines and primary literature to resolve questions, and as a medication expert for nurses and physicians.
During my rotation I had the privilege to work with three amazing critical care pharmacists who pushed me each and every day to expand my knowledge of the commonly used drugs in the ICU. On my first day of the rotation I assisted with CPR during a code. As I walked into the dimly lit room, the patient’s family members were standing in the corner of the room with tears welling in their eyes as their grandmother/mother was dying right in front of them. The patient was intubated and the nurse had already begun chest compressions when I entered the room. My preceptor asked if I was comfortable giving chest compressions, I nodded yes. He took my white coat and I walk toward the patient’s bed. The nurse asked me if I was ready. I thought, ready as I’ll ever be. But I just nodded yes.
She stopped compressions and I quickly aligned my hands, one on top of the other, over the patient’s chest. As I pushed down on her chest, I heard the tubing of the ventilator crackling in her bronchioles and blood was coming up from the ET tube. It was the scariest thing I’ve ever done. After about a minute and a half I asked my preceptor if I could be relieved. Shortly thereafter the physician came into the room with another family member and told us to hold CPR; the patient’s family had signed the DNR. The nurse took her hands off the patient’s chest, the ventilator and pumps were turned off, and most of the staff in the room left. I washed my hands, put my coat back on and followed my preceptor out of the room. It was perhaps the saddest, most thrilling thing I’ve ever witnessed. From then on I knew this would be a very different rotation, but most of all it would be the best rotation I’ve had so far.
Drunk or Not-Drunk? You be the Judge
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Thanks to Dr. Derendorf for bringing this to my attention.
Friday, October 9, 2009
Crack Discovered at Crystal River Power Plant
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OMG! Don't tell me that the operators of this nukie plant were found with Crack Cocaine? Oops. Should have read farther. They found a a crack in the concrete of the containment building of the Crystal River nuclear power plant, owned by Progress Energy.
Whew!!
If you want to read the whole story, here it is:
http://www.gainesville.com/article/20091009/ARTICLES/910089868
Thursday, October 8, 2009
"Just Spit." Test Detects Patients Who Don't Respond to Plavix
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Scripps Health hospital system has begun using a saliva-based genetic test to detect whether patients will respond to Plavix, a widely used blood thinner that usually prevents clots.
But recent studies show about one-third of people of European descent, and more than 40 percent of people of African and Asian descent don't properly respond to Plavix, putting them at increased risk of fatalblood clots. The new laboratory test from Quest Diagnostics detects four genetic mutations found in more than 90 percent of patients who won't benefit from the drug, which is marketed byBristol-Myers-Squibb andSanofi-Aventis. While older tests were capable of picking up the mutations, Quest says its test is the first designed for routine use and quick processing.
"It's so much simpler for patients because they don't have to undergo a blood draw, and that makes the process much more convenient for everyone involved," said Dr. Eric Topol, chief academic officer of Scripps Health.
Wednesday, October 7, 2009
It Took Only Two Weeks For "The Sign" to Go Up!!
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Dear Pharmacy Students,
Please read below the message from the University Policy Department regarding using trees in the Health Center Courtyard to park bicycles. Please adhere to this policy and save yourself money and aggravation in reclaiming your bicycle if you choose to disobey this request. Let's not harm the trees by locking bicycles to them. There are bicycle racks around the health science center that can be utilized and which may require you to walk further into the Health Science Center than a bicycle ride to the courtyard affords.
Thank you for your cooperation with this policy.
Sincerely,
Dr. McKenzie
"An officer from UPD came in yesterday and asked that I generate an email to all of the college's students letting them know that it is not alright to lock their bikes to the trees in our courtyard. He said there's been a real issue with this lately and that it's not only unattractive, it's hurting the trees. He wanted to warn the students that if it continues, they will get ticketed or their bikes will be removed from the trees."
Stuck Between "Botox" and "Toe Rings......"
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Tuesday, October 6, 2009
I Have "Inherited" $12 Million; I Feel so Lucky!
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Wowee, I'm Rich. Read the e-mail below and see how I have instantly become a millionaire. I feel so fortunate!! I may just be able to retire early!!
E-Mail receive 10/6/09:
Good Day,
I found your contact particulars in an E-mail address guide they provide us here, as I desperately need an urgent help to do this deal. I am seeking your kind assistance to move the sum of $12m {Twelve Million U.S Dollars only} to you in United States , as far as I can be assured that my share will be safe in your care until I complete my service here.
SOURCE OF FUND:
A lot of money in various currencies were discovered in barrels at a farm house near one of Saddams old palaces in Tikrit in Iraq during an operation Conquest in Fallujah north of Baghdad, and it was agreed by Staff Sgt. Kenneth Buff that some part of this money be shared among both of us before informing anybody about it since both of us saw the money first. This is quite an illegal thing to do, but well tell you what? no compensation can make up for the risk we have taken with our lives in this hell hole, of which my brother in-law was killed by a road side bomb last time.
The above figure was given to me as my share, and to conceal this kind of money became a problem for me, so with the help of a British Contact working here, at Southern Basra British fortified green zone, whose office enjoys some immunity, I was able to get the package out to a safe location entirely out of trouble spot. He does not know the real contents of the package, and believes that it belongs to a British/American medical doctor who died in a raid here in Baghdad, and before giving up, trusted me to hand over the package to his family in United States . I have now found a very secured way of getting the package out of Iraq to you, for you to pick it up, and I will discuss this with you when I am sure that you are willing to assist me, and I believe this my money will be well secured in your hand because you have a fear of God.
I want you to tell me how much you will take from this money for the assistance you will give me. One passionate appeal I will make to you is not to discuss this matter with anybody, should you have reasons to reject this offer, please and please destroy this message as any leakage of this information will be too bad and catastrophic for soldiers here in Iraq. I do not know how long we will remain here, but I hope to have a shift very soon for me to return back to the States. I have been shot and wounded twice and I have survived two terrible suicides bomb attacks just by special grace of God, this and other reasons I will mention later has prompted me to reach out for help, I will honestly want this matter be resolved immediately. You can contact me at sgtedwincurt@gmail.com
I thank you so much for everything and anticipate that you will be trustworthy and handle this transaction to the best of your ability to benefit both of us.Conatct me through my private email at sgtedwincurt@gmail.com
God Bless you and your Family.
Yours
Sgt. Edwin Curt
Would You Like Some Cocaine Vaccine to Go Along with that H1N1?
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Should the Color of Nasal Discharge Dictate the Medicine?
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We've all been taught that a thick, green-colored nasal discharge is a sure sign of bacterial infection. In fact, practitioners use this to determine if antibiotics are appropriate.
Every now and then new information comes along that calls into question these long-held notions. A recent article in the New York times reveals that the color of the discharge may be misleading.
A line from the story reminds us that "Old prescription habits apparently die hard."
Click on this link to find out more:
http://www.nytimes.com/2009/10/06/health/06real.html?emc=tnt&tntemail1=y
Monday, October 5, 2009
Will You Have a Job When You Graduate??
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Panasonic said Tuesday it has developed a medical robot that dispenses drugs to patients, the Japanese electronics giant's first step into robotics.
Panasonic spokesman Akira Kadota said the robot will cost several tens of millions of yen (hundreds of thousands of dollars).
"This robot is the first in our robotics project. It sorts out injection drugs to patients, saving time for pharmacists," said Kadota.
The robot does not look humanoid. "It looks like a cabinet with lots of small drawers," he said.
Pharmacists put drugs into the robot, which stores medical data for patients. The robot will then sort out drugs for each patient and place them into respective drawers bearing the names of patients.
Osaka-based Panasonic hopes annual revenue from the robot and other medical robotics will reach 30 billion yen ($315 million) in the financial year to March 2016.
Japan boasts one of the leading robotics industries in the world, and the government is pushing to develop the industry as a road to growth. Automaker Honda Motor Co. has developed the child-sized Asimo, which can walk and talk.
Earlier this year, the National Institute of Advanced Industrial Science and Technology, a government-backed organization, revealed a walking, talking robot with a female face. But it hasn't cleared safety standards and cannot yet help humans with daily chores.
Joke: The Hypnotist at the Senior Center (Rated R- language)
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDBCMAvWwtUpRGz0f-G93EZ4dWhz48DzqsH6Kht-rNIajGIsUsQz1vlbF4MK6icCPSzK2-MFuIgaW1Ix0J5X8iSxl5drKgge6PIhQ15lovxwXo_LpF_4m8SOfs-tOnHlmkezQUJOxo0qY/s320/hypnotist.jpg)
The excitement was almost electric as the hypnotist withdrew a beautiful antique pocket watch from his coat.
'I want you each to keep your eye on this antique watch. It's a very special watch. It's been in my family for six generations.'
He began to swing the watch gently back and forth while quietly chanting,
'Watch the watch, watch the watch, watch the watch ...'
The crowd of seniors became mesmerized as the watch swayed back and forth, light gleaming off its polished surface.
Hundreds of pairs of eyes followed the swaying watch, until, suddenly, it slipped from the hypnotist's fingers and fell to the floor, breaking into a hundred pieces.
'Shit,' said the Hypnotist.
It took THREE DAYS to clean up the senior center.
The Official Flat Stanley Project
Click on the link to find out more about Flat Stanley.
Click on the vdeo below to see a short video about Flat Stanley. Maybe we can start our own project to get Flat Stanley to "vist" all of the pharmacy schools in the US!
Thursday, October 1, 2009
Do You Know the Toxic Effects of Lidocaine During Liposuction? You Should!
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgf7NFlUOTqkOO3VXUXeZVt0d8yz_Ze5rhYBvmZkdzFopoFW5tIoS9WhyCVJ2i4TQ0lm4N63iSxFhaKEY6TBBv4D23skDGBbpcBc2lNvdy2uJJlPnlNzM-ShrvwgEnEvSlNjJ89RHqLsPA/s320/liposuction7.jpg)
The things we know about drugs sometimes we take for granted. Most of us know the side effects of drugs, but I am astounded at how often people are hurt through the careless and dangerous way drugs are used. This drug thing is hard, but not THAT hard. Why would people not know about the common side-effects of drugs?
This is a tragic case of a 37 year old patient named Rohie Kah who went to a spa for something called 'Carboxytherapy." Carboxytherapy is described on the Spa's website as a "medical service" that injects carbon dioxide into a patient to improve the appearance of cellulite or stretch marks. Now, this patient's family has been advised that "It's just a matter of time before she's dead."
The problem: most likely it was lidocaine toxicity. Watch this video and see if the clinical picture they describe is consistent with lidocaine toxicity:
What's more important is that the FDA put out a Public Health Advisory about this very thing back in January. Here is the link to that advisory. Sometimes people never learn:
http://www.fda.gov/Drugs/DrugSafety/PublicHealthAdvisories/ucm054718.htm