While new Hepatitis drugs are very expensive, the FDA now gives US blood banks a tool (a blood cleaning device) so that plasma may be transferred between people and not spread hepatitis, nor West nile. it is called the Intercept Blood system. It uses amotosalen (a synthetic psoralen) and UV light. After 704 people successfully used it, it passed muster.


Source: fda

To all future parents:

According to the 2012 edition of Volume 62, Number 9 of the CDC's "National Vital Statistics Reports" 3,952,841 people were born that year. Of those, 40-100 get an undesirable disease called  Severe Combined Immunodeficiency (SCID) yearly. Why is this relevant? Because if it is not detected the baby's lack of an immune system may result in death. 

This is where a Finish-American company comes in to improve life for babies. There product was able to find 17 positive cases and 6,383 negative cases out of 6,400 cases. It cannot detects related types of immunodeficiency: DiGeorge Syndrome, Omenn Syndrome, leaky-SCID or variant SCID.

It takes a few drops of blood from the baby's pes (trotter, tootsies, dogs, boats, or foot) to help count the number of T Cells. The number of births daily is estimated to be 10,829 a day. Hopefully the machine will be printing out 10,829 negative results.

According to an October article in Forbes the color of a pill may help patients think the pill works. They cited food coloring and made a comparison with salmon color and the type normally purchased. Reminds me of annatto food coloring in cheese. Incidentally that comes from this fruit. Though, it's supposed to be orange or yellow. So much for Wikipedia... though they would say don't look at the red seeds, it really is orange.
     Anyone want to think about the color is the blue and black dress that to some looked white and gold? 
wired.com/2015/02/science-one-agrees-color-dress
http://www.cnn.com/2015/02/26/us/blue-black-white-gold-dress/index.html

http://www.forbes.com/sites/sap/2014/10/22/the-shocking-truth-about-the-influence-of-colors/?sr_source=lift_outbrain

Want to pay less for a flu shot while being in the Dallas-FW area? Visit Walmart in Denton from 10-6 and give a toy only Dec 12-13.
Source: Dallas Morning News

Three days ago the FDA approved BLINATUMOMAB (BLINCYTO). It's a cancer drug, so expect side effects. REMS letters get sent out thrice at 6 month intervals to remind patients via their health care providers about cytokine release syndrome. It's typically manufactured in a 35MCG dosage form.
If the association for nurses, RPhs, or MDs requests a copy of the letter the FDA will provide it. The MSLs/drug reps will also have them. If Amgen happens to participate in a scientific meeting they also will be required to provide REMS info there. They also have to keep up http://www.blincytorems.com/ Here's the boxed warnings.
/////////////////////////////////////////

BOXED WARNING: Cytokine Release Syndrome

• Serious adverse events that may be associated with CRS included pyrexia, headache, nausea, asthenia, hypotension, increased alanine aminotransferase, increased aspartate aminotransferase, and increased total bilirubin.
• The highest elevation of cytokines was observed in the first 2 days following start of BLINCYTO infusion.

BOXED WARNING: Neurological Toxicities

• In patients receiving BLINCYTO in clinical trials, neurological toxicities have occurred in approximately 50% of patients.
• The median time to onset of any neurological toxicity was 7 days.
• Grade 3 or higher (severe, life-threatening or fatal) neurological toxicities following initiation of BLINCYTO administration occurred in approximately 15% of patients and included encephalopathy, convulsions, speech disorders, disturbances in consciousness, confusion and disorientation, and coordination and balance disorders. The majority of events resolved following interruption of BLINCYTO, but some resulted in treatment discontinuation.

Preparation and Administration Errors

• Preparation and administration errors have occurred with BLINCYTO treatment.
• It is very important that the instructions for preparation (including admixing) and administration are strictly followed to minimize medication errors (including underdose and overdose).

BLINCYTO Fact Sheet:

A non-promotional REMS Fact Sheet reviewed by the FDA, with more detailed information on the serious risks associated with BLINCYTO is available in the “Materials for Healthcare Providers” section above.

INDICATION:

BLINCYTO is a bispecific CD19-directed CD3 T-cell engager indicated for the treatment of Philadelphia chromosome-negative relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).
////////////////////////////////////
 
From FDA's new drug approval http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails

How does the Ferguson, MO trial and Occupy Wall Street (OWS) relate to RXs?
 OWS put out a blurb on twitter: Maalox may be part of a compounded medication to spray on your and your fellow protestors after just being sprayed with pepper spray.

Note from another site: use at your own risk, not for the inexperienced.

Considering all the problems with compounding, perhaps the wisest advice is to refrain from situations where one will need to be exposed to the offending agent.

Option two, it'll be self limiting so best not to use drugs. What's the benefit if the risk outweighs the benefit?

OWS also advise you to not trust the media. Since a Nature Made ad (put on the internet, a form of the media) says listen to RPHs, OWS (through a syllogism says shouldn't trust RPhs), but if one can't trust the media, one also shoudn't trust its own twitter-feed since it too is part of the media. :-)


http://www.zerohedge.com/news/2014-11-24/ferguson-grand-jury-decision-live-feed

On Corporations Merging together.... 
Picture from iconfinder.com.

Joe E. Lewis: "The way taxes are, you might as well marry for love."

Walgreen Co. Common Stock (WAG)

Alliance Boots Holdings Ltd (BOOT)

WAG Married BOOT, but Wag's foreign bride will not be taking WAG overseas. After much discussion, excoriation by the New York Times, and realization that inversion would also result in HIGHER taxation (BOOT'S COUNTRY WANTS prior year TAX REVENUE), the inversion was delayed indefinitely. Oh, also the prospect that Americans may not subsidize ¼ of the company's profits through medicare/medicaid in the future may play a role. The possibility that Americans would shop at other pharmacies instead played a role. The possibility that the IRS would audit, confiscate, fine, and sue WAG pharmacies also played a role. This created a bit of flummoxed faces on Wall St which expected WAG to flee to foreign soils in hopes of lowering its tax bills.

Image source:
https://www.iconfinder.com/icons/53253/marriage_party_rings_wedding_icon#size=128

From the Washington Examiner the following states have an airport which will be screening travelers from Ebola infected countries:

VA

IL

GA

NJ

NY

At least the Ellis Islanders will sleep better at night. Have some sympathy for them, only twelve years ago they and the Old Dominion suffered through 9-11. As for the rest of the country, they'll have to depend on the air lines and their public health system.

Tangential post because
(1) Wal-mart is a store that incorporates a pharmacy in its business model.
(2) There is a lot of concern about anti-bacterial resistance in humans, and some more seasoned peers say people do not mention that amount given to animals....
(3) Customers frequently like natural over synthetic. Numerous people ask "is there some herb I can take for my ailments instead of some pill?"
Walmart is attempting to bring organic food to its stores at prices similar to its non-organic products.

This article: "Wal-Mart Promises Organic Food for Everyone" By Andrew Martin
mentions examples where one organic product cost the same (or less) than a non-organic product. Walmart uses the Wild Oats brand. The examples were organic cinnamon applesauce, black beans and quinoa were either the same or cheaper than a non-organic version.

When I was younger I was told that "organic" meant no extra herbicides, pesticides, insecticides. Less chemicals in one's body. Sounds great. Normally one has to pay more for a better quality product. However, the article states that the organic producers are not producing in the most efficient manner. Wal-mart's size would allow for greater products produced at the same cost, which is more efficiency. If it is possible due to economies of scale, then so much the better for the consumer that has a demand for organic foodstuffs selling for the same price as a non-organic version.

For the full text read page one and two below:

http://www.businessweek.com/articles/2014-11-06/wal-mart-promises-organic-food-for-everyone#r=shared

http://www.businessweek.com/articles/2014-11-06/wal-mart-promises-organic-food-for-everyone#p2

An online ebola survey from Drug Topics had over 2/3s of responders doubting the local hospital could cure an ebola outbreak.

Meanwhile in California, on the horizon: Plastic bags targeted for removal, and it is not just in pharmacies. For the full criteria of stores see the end of this blog*.

Existing California law requires store owners to recycle plastic bags on site until 2020. Paper bags will be available, but only if the customer pays a dime per paper bag. Starting July 2015 "compostable bags" will be available in limited areas for a price of at least a dime, but it could be higher. 

All subsequent quotes will be from the law 
http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201320140SB270

For the technical policy wonk it is: CHAPTER  5.3. Single-Use Carryout Bags

Reusable bags would be available if:
"certified reusable grocery bag producer and to meet specified requirements with regard to the bag’s durability, material, labeling, heavy metal content, and, with regard to reusable grocery bags made from plastic film on and after January 1, 2016, recycled material content."

Failure to comply with the law is inadvisable:
"The bill would allow a city, county, or city and county, or the state to impose civil penalties on a person or entity that knows or reasonably should have known it is in violation of the bill’s requirements. The bill would require these civil penalties to be paid to the office of the city attorney, city prosecutor, district attorney, or Attorney General, whichever office brought the action, and would allow the penalties collected by the Attorney General to be expended by the Attorney General, upon appropriation by the Legislature, to enforce the bill’s provisions."

Plastic bag companies are going to have to design a re-usable bag for California To lessen the pain the state will allow for funding in the form of loans & tax credits:

"(e) Applicants for funding under this section may also apply for funding or benefits from other economic development programs for which they may be eligible, including, but not limited to, both of the following:

(1) An income tax credit, as described in Sections 17059.2 and 23689 of the Revenue and Taxation Code.

(2) A tax exemption pursuant to Section 6377.1 of the Revenue and Taxation Code."

Loans are also available.

42288.

 (a) Notwithstanding Section 42023.2, the sum of two million dollars ($2,000,000) is hereby appropriated from the Recycling Market Development Revolving Loan Subaccount in the Integrated Waste Management Account to the department for the purposes of providing loans for the creation and retention of jobs and economic activity in this state for the manufacture and recycling of plastic reusable grocery bags that use recycled content, including postconsumer recycled material.

(b) The department may expend, if there are applicants eligible for funding from the Recycling Market Development Revolving Loan Subaccount, the funds appropriated pursuant to this section to provide loans for both of the following:

(1) Development and conversion of machinery and facilities for the manufacture of single-use plastic bags into machinery and facilities for the manufacturer of durable reusable grocery bags that, at a minimum, meet the requirements of Section 42281.

(2) Development of equipment for the manufacture of reusable grocery bags, that, at a minimum, meet the requirements of Section 42281.

(c) A recipient of a loan authorized by this section shall agree, as a condition of receiving the loan, to retain and retrain existing employees for the manufacturing of reusable grocery bags that, at a minimum, meet the requirements of Section 42281.

(d) Any moneys appropriated pursuant to this section not expended by the end of the 2015–16 fiscal year shall revert to the Recycling Market Development Revolving Loan Subaccount for expenditure pursuant to Article 3 (commencing with Section 42010) of Chapter 1.

The 5 types of stores that qualify:

(1) A full-line, self-service retail store with gross annual sales of two million dollars ($2,000,000) or more that sells a line of dry groceries, canned goods, or nonfood items, and some perishable items.

(2) Has at least 10,000 square feet of retail space that generates sales or use tax pursuant to the Bradley-Burns Uniform Local Sales and Use Tax Law (Part 1.5 (commencing with Section 7200) of Division 2 of the Revenue and Taxation Code) and has a pharmacy licensed pursuant to Chapter 9 (commencing with Section 4000) of Division 2 of the Business and Professions Code.

(3) Is a convenience food store, foodmart, or other entity that is engaged in the retail sale of a limited line of goods, generally including milk, bread, soda, and snack foods, and that holds a Type 20 or Type 21 license issued by the Department of Alcoholic Beverage Control.

(4) Is a convenience food store, foodmart, or other entity that is engaged in the retail sale of goods intended to be consumed off the premises, and that holds a Type 20 or Type 21 license issued by the Department of Alcoholic Beverage Control.

(5) Is not otherwise subject to paragraph (1), (2), (3), or (4), if the retail establishment voluntarily agrees to comply with the requirements imposed upon a store pursuant to this chapter, irrevocably notifies the department of its intent to comply with the requirements imposed upon a store pursuant to this chapter, and complies with the requirements established pursuant to Section 42284.

Since 2010 APHA has been hoping that RPHs would not sell tobacco. They partly got their wish with CVS. It stopped selling in September, when it planned on ceasing sales 9 days from today.

In other news, the DEA is giving hospitals and clinics the ability to start collecting unwanted medications any day of the year. No longer are they limited to DEA take back days ever since 9/8/14 when they issued what is sometimes called a "final rule" on the subject of how to throw away  controlled RXs. For most pharmacists, beware of accepting illegal medicine. Follow the rule: to take back from patients only marinol, not marijuana.

Source: Pharmacy Today

To any RPH who wants to import medicine for their pharmacy..... Please make sure you have filled out all your importation forms. Do not imitate a RPH who was convicted of importing without a license. For more, check out the article in Drug Topics. It is available here http://drugtopics.modernmedicine.com/drug-topics/news/pharmacist-accused-internet-fake-pill-scheme?page=0,1

After reading an older article in US Pharmacist here are some thoughts:

Is your CPR up to date so that you can immunize? That may be needed.

Are you seeing a spike in flu like symptoms? It's time to call the health department.

Inhaled anthrax isn't contagious, but the flu is. Most likely your patients may need to see the article printed out to believe you, but if you have your white coat on you may be more credible, unless you are worried about white coat induced hypertension of your patients. 

http://legacy.uspharmacist.com/oldformat.asp?url=newlook/files/Feat/Bioterrorism.htm&pub_id=8&article_id=798

The CDC has tips on what should be in your prep kit. 

http://www.bt.cdc.gov/preparedness/kit/disasters/

Did you know? There are five titles to the Bioterrorism Act of 2002, and you can get electronic updates.

On a more morose note here's an article from last year that talks about a California RPH who went to jail because he helped Pakistanis attack US soldiers. 

http://www.huffingtonpost.com/2013/03/29/oytun-ayse-mihalik-sentenced_n_2981266.html

I skim the slideshows at dictionary.com occasionally. They even have a word of the day email. It helped me out one day when I was talking to a classmate, and he said "I've never heard that word before, what does it mean?" On another day, another person jokingly implied I should have job security because of my vocabulary skills.

Dictionary.com claims that there is only 1 word in the english language that has X, Y, and Z in the word. Atarax. Hydroxyzine.

This is why chemistry is useful to learn. There are carbon bonds, hydrogen bonds, etc. There are single and double bonds. A good chemistry student will know if the chlorine was ortho, meta, or para....

Yes there is a link between today (911) and pharmacy.

Andy Stergachis, professor of epidemiology and affiliate professor of pharmacy for University of Washington, had the following commentary on the role of a RPH during a disaster:

Who is your health departments "health officer" ?

Which agents would villains like to use to harm your neighbors, and what preventive antibiotics might be useful for you to have in your pharmacy?

What local clinics would need a volunteer RPH?

Do you have time (and money) to take a training class on how to prepare for an ER?

Here's the washington state link:

http://www.wsparx.org/emergencyprep

Here's some link to the FDA page & CDC's pages:

http://www.bt.cdc.gov

http://www.fda.gov/EmergencyPreparedness/Counterterrorism/default.htm

Hear ye, hear ye community pharmacy staff…..want a free CE? Especially one that may help you do your job better? It's more than 12 months old, but less than 24.I just discovered it.

https://www.humana.com/provider/support/on-demand/linet

https://www.brainshark.com/humana/2013LINET

Interesting, that insurance companies are allowed to make CEs, but manufacturers aren't. Though, after a brief recollection of Pharma's behavior most RPHs know why manufacturers aren't.

Humana made a 1 CE module about Limited Income NET Tutorial. Brief registration including your NABP number is required. Techs can also take it for credit.  Here's the 9 aspects of it:

1. List the four categories of individuals eligible for the program. 
2. List the four steps required to submit a claim. 
3. Identify the bank identification number (BIN) and processor control number (PCN)
   required to submit claims to the program. 
4. Extract required beneficiary data for claim submission. 
5. Describe temporary enrollment. 
6. Extract data from E1 transactions. 
7. Define what retroactive coverage is for Medicare’s Limited Income NET program. 
8. Identify members eligible for retroactive coverage in the program. 
9. Identify additional Medicare Limited Income NET Program resources available via the
   Web and the dedicated Limited Income NET Help Desk. 

• Accreditation
  Humana Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The Universal Program Number for Pharmacists is 0619‐0000‐ 13‐019‐H04‐P. The Universal Program Number for Pharmacy Technicians is 0619‐0000‐13‐019‐ H04‐T. 

Speaking of Marijuana

Here are three photos of marijuana products manufactured in the US prior to the rescheduling of the product by the DEA. You'll notice that two have poison on the bottle, and one does not. Perhaps the product should be regulated the same way as Psuedophedrine, behind the counter? Perhaps the US should have products which require patients to speak to a pharmacy worker first? Do our Australian cousins have it right (which have 3 types of medicines: RX, OTC, and behind the counter)? I have no knowledge of what schedule Australia considers marijuana. Image source: wikimedia commons.

https://commons.wikimedia.org/wiki/Cannabis_sativa#/media/File:Lilly96B.jpg

https://commons.wikimedia.org/wiki/Cannabis_sativa#/media/File:Lilly96A.jpg

Medical Marijuana Study.

So NABP makes a blurb about The study “Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010,”

Please note is that consumer use wasn't legalized in Washington and Colorado until 2012.  Medical marijuana may play a role? Yes, from a historical standpoint marijuana was in use in prior centuries in the US, but despite various lawsuits, even most Americans grew up only knowing that it was illegal.

The abstract mentions that three left coastal states of the lower 48 had medical marijuana before 1999. From then until 2010, 10 more states passed it. Authors assert that each year there was less opioid overdose deaths in states with marijuana access than without. 

So how does that reconcile with the fact that the very components of marijuana which reduce pain, are also associated with mental imbalance and a lack of cognitive thinking? (Source DrugStoreNews CE by medical marijuana expert).

The authors do not reconcile that point.

How about the fact that for almost everyone, an otherwise illegal substance, is legal if you're *really* sick and in pain. 

Thus, the authors say: more studies and time are needed.

Another aspect not always mentioned is that the younger generation wants it legal because they believe it is not as harmful as other illegal drugs. There is the belief among the young that they are invincible. Though also, let's not forget the impact that TV shows can have on one's belief's.
There's the fact that when alcohol was made illegal during prohibition and we had gangsters making money off its sale, and so libertarians like the now deceased Milton Friedman say "Well if we decriminalize it, maybe the drug traffickers will not be able to make a profit motive selling it illegally so lets try this social experiment."

What to do, what to do? Ah controversy....

National take back day……Saturday, September 27, 2014

Be aware.    Got drugs? Perhaps you have some you really don't need?

So the number of unintentional overdose deaths in NYC has gone from 638 in 2000 792 in 2001 remained in the 700s until 2005 (796) then increased to 828 in 2006 then shrunk to 695 in 2007, 618 then 593 then a low point of 541 in 2010 then increased 630, 730, then 782 in 2013. Politicians can't take credit for such bizarre movements of overdosing.  Of course based on statistics one can talk about the DRAMATIC RISE from the low point of 541 to the scary top of 782. over a 3 year period.  Many of them were from opioids (77%). 

     Di-acetyl morphine, which doesn't cause addiction in the UK (according to one website), is a menace to the Empire State, or at least Empire City. It is involved slightly more than half (54%)* of the overdoses. Here's a great example of percentages versus figures. Heroin killed 50% more people PER CAPITA in 2013 than it did in 2010. Here's the numbers: 209 versus 420. 

    Methadone's per capita rate is similar between 2008 and 2013 (2.4 vs 2.5 per 100,000). Most people needed to take 2 drugs to overdose. Anxiety medication was used 60% of the time. 

* 420/.54 = 777.8       778*.54~420 so I'm unsure why in the graph it has 782 as the # of unintentional deaths, but I doubt that one needs to quibble about math since there was an annotation that numbers may be changing. Bronx inhabitants eked out Staten Islanders (8.8 vs 8.6 per 100,000) in overdosing. The largest increase by ethnicity was among Hispanics/Latinos, but the largest group of people who died was Whites. Heroin is most commonly used by poor people. So, yes Virginia, poverty knows all racial groups. 

Source: http://www.nyc.gov/html/doh/downloads/pdf/epi/databrief50.pdf

A recent study from Radiology showed that iron absorption was abnormal (low) in patients with ADHD. This was based on 22 kids with it and 12 who never took any medications for it. There were 27 controls. It was coauthored by Helpern and Jensen (both PhDs). Of the kids with ADHD those on medication had higher iron levels than those who hadn't been on it. It was performed at the medical University of SC. I wonder though, how many of the families were meat eaters?

Less screaming at the doctor's office or pharmacy now that the CDC thinks it oks for kids 2-8 to get the inhaled flu vaccine instead of getting a shot. Honestly, who enjoys having a metal tube inserted into one's skin? Who looks forward to that senation of alcohol chilling the skin as its rubbed on and then possibly fanned on the arm? It's supposed to be better in terms of efficacy.
Minutia from the CDC memo, back in 2010 almost everyone at least 6 months old was asked to get a flu vaccine.

Here's the CDC link:
http://www.cdc.gov/media/releases/2014/s0625-acip.html

http://drugtopics.modernmedicine.com/drug-topics/news/cdc-panel-recommends-nasal-spray-flu-vaccines-some-children
CDC panel recommends nasal spray flu vaccines for some children

Memo to the RPHs of the country, be honest when you file your tax returns.


From the IRS's website.:
Ohio Pharmacist Sentenced for Failing to Pay Taxes
On June 4, 2012, in Youngstown, Ohio, Ronald E. Lidderdale, of Magnolia, Ohio, was sentenced to 12 months and one day in prison and one year of supervised release for failing to file federal income tax returns. According to a written plea agreement, Lidderdale, who owned and operated a pharmacy and gift shop, failed to file income tax returns on which he was required to report adjusted gross income of approximately $249,497, $336,800, and $324,734 for 2004, 2005, and 2006, respectively. Lidderdale failed to pay approximately $281,341 in income taxes owing on that income.

https://freerangestock.com/sample/997/photo.jpg

Minutia about pharmacy:

"Ben Shalom Bernanke's parents owned/operated a pharmacy." Source: DrugStoreNews.

File this under weird pharmacy news.

A guy robs a CVS. His brother manages it. Is it the case of an inside job? Well read below to find out. Then again, who ever heard of sticking someone up not with a water gun, but a water nozzle? The entire article is copied below.
It's not quite as strange as a guy hitting a pregnant relative with a cheeseburger & pushing her because he disagrees with something she said, or an adult acting out because he can't play certain games, though normally children act out, not adults.

• Man issues threat over loss of game privileges

  A 29-year-old man was arrested after allegedly threatening his mother with a knife when she told him if he didn't do his chores, he would lose his game privileges. READ MORE

http://www.nwfdailynews.com/local/crime/police-blotters/report-man-hits-pregnant-woman-with-cheeseburger-1.326180

Naples man accused of robbing store with water hose nozzle

Posted: May 29, 2014 1:25 PM CDT Updated: May 29, 2014 6:18 PM CDT

By Bryan Anderson, Collier County Reporter - email

 

A man armed with a water hose nozzle is accused of robbing a Naples CVS store managed by his own brother.
Akeem Rendell Arnold, 23, of Naples, allegedly tried to steal over $14,000 shortly before closing, according to a police report.
Police say Arnold wearing a mask and dressed in black approached the store manager, who is his brother, while he was outside taking the trash out.
Arnold allegedly put what felt like a gun or knife to the manager's back and told him to re-enter the store against his will at 294 9th street South, according to the police report.
Once inside the store, Arnold is accused of hitting the manager over the head with the garden hose nozzle, taking money from the store's safe, and hog-tying him with a roll of plastic wrap.
Arnold then made a run for it, and police apprehended him along US-41 with a backpack containing the money, the garden hose nozzle, a mask, bandana and multiple pairs of gloves.
Reports show it took two pepper sprays and handcuffs to get Arnold under control.
Customers on Thursday were surprised by what happened.
"If that's true, that's really really shocking to hear that, and surprising what can happen within families," said Glynn Huntington, CVS customer.
Naples police lieutenant John Barkley credits the CVS manager, David Arnold's quick thinking for getting Akeem Arnold caught so quickly.

In Texas marijuana is illegal under state and federal law. In other states the law allows marijuana though federal law prohibits it. Last December a driver who used alcohol and Tetrahydrocannabinol (THC) was impaired & pulled over at 0200 (2 am). According to reports his "blood-alcohol content was at .155, just short of twice the legal limit. It also showed trace amounts of tetrahydrocannabinol, the intoxicating component in marijuana." 

It is something to think about, as one reason to advocate marijuana decriminalization or legalization is the THC to reduce pain. Yet, it is also the THC which impairs one. So to anyone who smokes weed, don't smoke and drive, nor drink and drive. Tragically this combination led to a pharmacy student's death after being pulled over and shot by a policeman.

This is more tragic because a pharmacy student studies drugs and its effects on the body. though illegal substances aren't normally the scope of pharmacy school, legal ones are, including ethanol or alcohol. Judging by the amount of drinking that some of my peers did, knowledge doesn't always led to correct decisions of moderation of imbibing.

Source:http://www.dcclothesline.com/2014/03/23/autopsy-determines-texas-cop-fatally-shot-student-back/
'Autopsy determines Texas cop fatally shot student in back'

I'm continuing my monthly blog. My goal is to write one short summary or reflection in response to a pharmacy news story/stories.

Today is the filing deadline for US Taxpayers. It is the time to consider tips and altering one's behaviors based on the tax code. How does this relate to pharmacy? One retail chain is mulling changing its headquarters to lower its tax bill, just like Apple did.
Employees of Walgreens (WAG) may imitate employees of Giant Pharmacy whose company went from being a domestic corp to an international corp with a HQ overseas. Various investors commented that the US corporate tax of 37.5% was higher than Switzerland's 20%. If the company change occurs at least 1/5th of stock most be held by foreign investors.

Source: yahoo and telegraph though there's an article in businessweek too.

Reflections on Pharmacy: I felt really sad when I read this because I know ...

Reflections on Pharmacy: I felt really sad when I read this because I know ...: I felt really sad when I read this because I know what it is like to be in pain. When I had my wisdom teeth removed it was so painful I ha...

Blog reaction to DEA PR:

People respond to incentives. If you fine someone , it's a disincentive. If you can fire someone, it's a disincentive. At first I thought that the millions of dollars in Walgreens fines didn't matter as the company' analysis said "this will only affect share prices by a few cents." This led to many saying that the government did not fine Walgreens enough. Yet, then Walgreens roled out a plan to determine if a drug was "validly written." 

To the non-pharmacy workers of the world this was always a federal and state requirement. There are numerous times I have told patients that they are multiple days early and it couldn't be filled. One patient said to me, "I will have to come back in a day or two in order to pick it up. What's the difference between a couple days?"

The difference is whether I will lose my job. How will this happen? Will the state board feel I was reckless in dispensing? Will a federal agent come in, accuse me of aiding a drug addict? Will the police storm a store or hospital and demand to cuff myself, a subordinate, or a supervisor and take us away?

If I work for Walgreens or CVS will they fire me for dispensing this medicine? Will they say, "Sorry, this is coming out of your paycheck?"

Reaction to DEA PR [on enforcement of DEA regulations]:

People respond to incentives. If you fine someone , it's a disincentive. If you can fire someone, it's a disincentive. At first I thought that the millions of dollars in Walgreens fines didn't matter as the company stock' analysis said "this will only affect share prices by a few cents." This led to many health care workers and customers saying that the government did not fine Walgreens enough. Yet, then Walgreens roled out a plan to determine if a drug was "validly written." 

To the non-pharmacy workers of the world this was always a federal and state requirement. There are numerous times I have told patients that they are multiple days early and it couldn't be filled. One patient said to me, "I will have to come back in a day or two in order to pick it up. What's the difference between a couple days?" When I said that I would not give it to him early he got angry. 

There have been other people who ran out of their medicine early. When confronted that they were given a certain quantity and were only to take a certain amount per day it became obvious they took more than they were allowed to, but they did not appear to have any adverse effects other than fearing withdrawl symptoms.

The difference is whether I will lose my job. How will this happen? Will the state board feel I was reckless in dispensing? Will a federal agent come in, accuse me of aiding a drug addict? Will the police storm a store or hospital and demand to cuff myself, a subordinate, or a supervisor and take us away?

If I work for Walgreens or CVS will they fire me for dispensing this medicine? Will they say, "Sorry, this is coming out of your paycheck?"