It's Halloween. What costume character could signify mental illness? lycanthrope when in reference to a mental impairment that one really can become a werewolf / lycanthrope.

"the case of Pfizer, it reported an effective tax rate of about 25 percent in its most recent filing. Allergan's is reported to be significantly lower, thanks in part to Ireland's 12.5 percent statutory"

"The threat of Pfizer moving its headquarters outside the U.S. would realize the fears of lawmakers such as newly installed House Speaker Paul Ryan, who has sought to reform the corporate tax code. It also has drawn the ire of Democratic lawmakers..."

Us pharmacist has an article on new drugs that came out. One involved hepatits drugs. Such drugs would've helped out actress Veronica Lake who years ago succumbed to hepatits after a bout with alcoholism that also earned her a derisive nickname per wikipedia.

The street.com asserts that inhaled insulin isn't popular.

The nascent commercial launch of Afrezza continues to resemble a train wreck. MannKind's signature product contributed only €2 million to Sanofi's sales in the third quarter. That's flat with second quarter sales despite Sanofi's upgraded efforts to convince U.S. doctors to prescribe the inhaled insulin to their diabetes patients. Through nine months of 2014, Afrezza sales have totaled €5 million, well below Sanofi's expectations.

What is the cost of this pharmacy school that has a campus in alaska?
The cost for Alaska students (or students who are residents of other states than idaho) will be $17,561 per semester for the 2015-2016 academic year.

It's like a bad dream. Speaking of dreams:  or relating to dreams: oneiric. That is the basis of the movie brigadoon.

While watching brigadoon there was an approximate interesting quote from a lass to Van Johnson's character about attraction, "looking at you makes tadpoles in me spine jump. " speaking of the apine, software was made to make spine procedures less costly. From Pharmacy times:

The new Cardinal Health Inventory Management Solutions OR workflow modules help hospitals maintain chain of custody documentation, identify unused inventory for returns, and avoid product expiration. The solution integrates with electronic medical records and other hospital IT systems for more accurate charge capture and interoperability. Through the use of RFID tagging and barcode, the modules provide full visibility for day-to-day management and enable long-term inventory planning

In a case of misbranding, a recall had been issued. Is it APAP 325 or 500mg?

 On October 9, 2015, Medline Industries, Inc. announced that it will initiate a voluntary nationwide recall of lot # 45810 of Acetaminophen tablets, 500mg, uncoated compressed tablets to the consumer level. The Acetaminophen 500mg, Tab 100/BT (OTC20101) has been found to be mislabeled displaying “Acetaminophen 325mg” (OTC10101) instead of “Acetaminophen 500mg”. The Acetaminophen tablets, 500mg is incorrectly labeled as 325 mg tablets. This error is not easily identifiable by the user or prescriber. If the product is taken at the maximum labeled dose, every four hours, five doses a day, or with other medications containing acetaminophen, it may lead to liver toxicity or liver failure. See the firm Press Release for further details.

The more blood needed to be added to a patient the higher chance of death. Researchers surprised that it only st a 1:1 ratio and not steeper.
Medical vs surgical patients had slightly different outcomes based on initial sicknesses / damage to the body.
From Clinical Anesthesiology.

“As anesthesiologists in the OR [operating room], we were giving coolers and coolers of blood, and we often wondered whether the patients survived their hospital stay,” Dr. Frank said. “We didn’t know the outcomes because we only dealt with OR. We decided to see if they survived, and also looked at the relationship between blood dose and in-hospital mortality. Perhaps more importantly, we also looked at five different morbid events,” he explained. We also wondered whether there was a point at which it becomes futile to continue giving massive transfusions,” Dr. Frank added. “It turns out the answer is no. A 50% survival rate is pretty good compared to other conditions, such as pancreatic cancer surgery, where the survival rate is about 20%. We don’t see a point of futility, and our recommendation is not to give up.”

“This is an important paper,” concluded Dr. Papadakos. “It shows that you get 50% mortality after giving 50 units of blood.” He added, “I’m surprised that it’s that low.”

Chickadee magazine claimed that carrots used to be purple. About.com lists other colors. Feel free to read it below.
Photo from about.com.

"
•Red Carrots

Red carrots don't differ in taste much from orange carrots. Their red color, though, comes from lycopene, the heralded antioxidant in tomatoes.


• White or Golden Carrots

White or golden carrots are yellow or cream colored. They have a mild flavor with hardly any of the earthiness of other colors, and they're a bit sweeter than orange, red, or purple carrots"

Perhaps this future chemist will become a RPH working for a manufacturer or return to academia? This is a Horatio Alger story of an immigrant's son who seems to have made good. It's always nice when the next generation has more opportunities that the last one.

http://www.rgj.com/story/news/2014/12/05/snakes-unr-chemistry-grad-venomous-research/19974027/

Boris Zhang spent part of his undergraduate career at the University of Nevada, Reno, working on a project of Ruben Dagda, assistant professor in the molecular biosciences graduate program, along with Indira Shrivastava, that looked at atom-to-atom interactions, where one protein in a snake venom was more potent than another.

Are you taking pradaxa, but worried about bleeding? The FDA has a pill for you. Source: FDA press release.

"The FDA has granted accelerated approval to Praxbind (idarucizumab) for use in patients who are taking the anticoagulant Pradaxa (dabigatran) during emergency situations when there is a need to reverse Pradaxa’s blood-thinning effects."

Older news, but still from 2015.
An employee was diagnosed with a needle phobia. Then he brings in documentation of the diagnosis. He asks not to inject others as he may harm them.

Can you imagine a nurse giving you your childhood injection only to fall as she is placing it into you?
The employee is fired. Lawsuits happen, and the state says the employee's rights have been violated.

For more see below or go to Pharmacy Times' website.
-----------

Fired Pharmacist with Needle Phobia Wins $2.6 Million Verdict

Meghan Ross, Associate Editor

Published Online: Tuesday, January 27, 2015

Six days into trial, the jury determined that Rite Aid was wrong; the pharmacy chain had violated the ADA and state law.

“We’re very happy the jury put Chris back in a place he would have been had Rite Aid followed the law and worked with him and made accommodations,” Steven’s attorney, Daniel B. Berman of Hancock Estabrook Law Firm, told Law360.

From Nabp, basically inspectors felt the conditions were not sanitary. The company said they were and has not issued a recall. Keep aprised if an injunction gets issued:

FDA Issues Alert to Discontinue Use of Sterile Drug Products Made by Chen Shwezin Inc, dba Park Compounding Pharmacy

Henry marsh's book, "Do no harm," has stories of NHS England and post USSR Ukraine.  The training programs residency over there are as demanding in long hours as they are in the states. I have heard of some Americans going to an Irish or English med school right after high school in hopes of  skipping her undergrad of 4 and 4 and instead spend 6 years studying overseas. However, I know of one med student who went to a different foreign medical school who said it was tougher to get a residency in the US.

In the odd world of nutrition, Mari Johnson (youtube travel channel) interviewed 2 russians who said that in their country salad had a connotation of mayo and meat along with potatoes not lettuce with other vegetables. Something to bear in mind if counseling patients.

Costumes and Fines

Pharmerica had to pay 9 M in fines due to allegations it promoted drug use for its nursing home patients in part because of manufacturer educational grants. This represents a settlement. Source: drug topics.

In the sillier world of dress up / costume playing / ie cosplay: a Thor was seen thanks to a Physical Therapy student which was the last one. No pharmacists were photographed at the comic convention. Most of the photos are of inanimate items with a white board which is why the writer felt the costumers were " unbelievable." For instance one was really just a trash can.
The 12 Most Unreal Comic Con Costumes, And The...

I have done other compounding. For clarification this is not me, but I thought it would be of note to know what some people are paid to create.


From imgur: "As a compounding pharmacist I get to make unique and interesting things every day. Meet the 'Rectal Rocket'."

If you visited Inova or a certain virginia Costco recently, hopefully you had your MMR vaccine already.

http://wtop.com/fairfax-county/2015/10/child-who-contracted-measles-visited-several-fairfax-county-locations/

Charles Lamb 1775 - 1834
"For thy sake, Tobacco, I would do anything but die." in a farewell to tobacco.

"This very night I am going to leave off tobacco! surely there must be some other world in which this unconquerable purpose shall be realized." letter to Thomas manning 1815.

"books think for me." last essay of Elia. Detached thoughts on books and reading.

How sickness enlarges the dimension of a man's self to himself.  last essay of Elia. The convalescent.

Also for those who have interest in the topic:

  
Opioid Use Disorder and Depression: Surprising Findings, Treatment Translations 

Tuesday, October 13 and October 27 (Case Discussion)
at 12:00 - 1:00 pm ET

Webinars sponsored by American Psychiatric Association (APA)

From the Los Angeles Times:

Nearly two decades after Californians legalized marijuana for medical use and a year before they may also approve it for recreational purposes, Gov. Jerry Brown today approved statewide rules on the growth, trans

Imagine a patch that permantly changes skin tone. From a top 10 list. Link below:

"10. Methylphenidate transdermal system (Daytrana patch) The FDA issued a safety alert about the ADHD medication Daytrana patch in late June over reports of permanent loss of skin color up to 8 inches in diameter.   Although it is not physically harmful, the condition is believed to be irreversible. In fact, no signs of reversibility have been seen in the 51 related chemical leukoderma cases reported to the FDA.   In most cases, the skin color loss was concentrated in the area where the patch was applied, but there have been some reports of the discoloration spreading to other parts of the body.   Health care professionals are encouraged to consider alternative treatments for patients experiencing this side effect."

See more at: http://www.pharmacytimes.com/product-news/10-fda-drug-warnings-pharmacists-should-know#sthash.AaZ42AJT.dpuf

Want to have nationally certified warnings on your pharmacy labels? The US has you covered.

http://www.usp.org/usp-healthcare-professionals/related-topics-resources/usp-pictograms

And in other news the FDA gas to issue an injunction against a device makwe who despite warnings was trying to sell / market his device for unapproved use. The irony it was approved for hand arthritis, just not HIV.

"Although the FDA cleared two of the QLaser devices for providing temporary relief of pain associated with osteoarthritis of the hand (as diagnosed by a physician or other licensed medical professional), the FDA has not cleared or approved any of the devices to treat any other medical conditions. Further, as demonstrated by the evidence presented at trial, use of the QLaser devices according to the labeling could be dangerous to the health of the consumer."

Today's tweets:


Novartis  @Novartis What do sweet wormwood and the#NobelPrize have in common? Learn here:nyti.ms/1M86oywView on Twitter


Johnson & Johnson   @JNJNews #JNJ congratulates #NobelPrize winners William C. Campbell, Satoshi Ōmura & Youyou Tu for research on #NTDs:bit.ly/1NiYNibView on Twitter


GSK US  @GSKUS Congratulations to @NobelPrize winners for efforts against roundworm parasites + malaria! #NobelPrize #fightmalariaow.ly/T2yB8View on Twitter


Pfizer Inc. @pfizer Congratulations to #NobelPrize in medicine winners William C. Campbell, of@DrewUniversity; Satoshi Omura of Japan & Youyou Tu of China

Scratching one's lips...it could happen. If they do have pain and take Nsaids one could have bleeding lips.

In clinical trials, 79% of patients who received the dermal filler showed a meaningful improvement in lip fullness 3 months after treatment, and more than 78% reported an improvement in their overall satisfaction with the look and feel of their lips at 1 year. The most common side effects of Juviderm XC injectable gels occur at the injection site and include redness, swelling, tenderness, pain, discoloration, and itching.

 Source: http://www.pharmacytimes.com/product-news/fda-approves-lasting-filler-for-lip-augmentation#sthash.WUPlff8c.dpuf

Make sure you stay hydrated unlike this lady. Image chosen because as Fed Chairmen the symbolic importance of piggy banks seemed relevant. Chairman Yellen was taken to the local Massachusetts hospital.

http://www.washingtonexaminer.com/feds-yellen-appears-to-fall-ill-during-speech-fed-cites-dehydration/article/2572788

From the Chicago Tribune from last week:

"Walgreens' pharmacy computer database went down Tuesday, forcing pharmacists at all 8,200 Walgreens stores nationwide to fill prescriptions manually.

But on Friday morning, Walgreens spokesman Jim Cohn said that the problem had been fixed at most of the suburban Chicago company's stores."

I imagine this is the face of the typical geriatric customer when they got the bad news. Luckily good news wasn't that many days later.

"
Read more here: htt

Fp://www.s

acb

e.com/news/news-services/article36561477.html#storylink=cpy

From The Lancet

"Controlling overnight glucose with dual-hormone, single-hormone, and conventional insulin pump interventions Aug 25, 2015

The dual-hormone artificial pancreas could possibly improve nocturnal glucose control

Background

Additional benefits of the dual-hormone (insulin and glucagon) artificial pancreas compared with the single-hormone (insulin alone) artificial pancreas have not been assessed in young people in outpatient unrestricted conditions. We evaluated the efficacy of three systems for nocturnal glucose control in children and adolescents with type 1 diabetes.

Methods

We did a randomised, three-way, crossover trial in children aged 9–17 years with type 1 diabetes attending a diabetes camp in Canada. With use of sealed envelopes, children were randomly assigned in a 1:1:1:1:1:1 ratio with blocks of six to different sequences of the three interventions (single-hormone artificial pancreas, dual-hormone artificial pancreas, and conventional continuous subcutaneous insulin pump therapy). Each intervention was applied for 3 consecutive nights. Participants, study staff, and endpoint assessors were not masked. The primary outcome was the percentage of time spent with glucose concentrations lower than 4·0 mmol/L from 2300 h to 0700 h. Analysis was by intention to treat. A p value of less than 0·0167 was regarded as significant. This study is registered with ClinicalTrials.gov, number NCT02189694.

Findings

Between June 30, 2014, and Aug 9, 2014, we enrolled 33 children of mean age 13·3 years (SD 2·3; range 9–17). The time spent at a glucose concentration lower than 4·0 mmol/L was median 0% (IQR 0·0–2·4) during nights with the dual-hormone artificial pancreas, 3·1% (0·0–6·9) during nights with the single-hormone artificial pancreas (p=0·032), and 3·4% (0–11·0) during nights with conventional pump therapy (p=0·0048 compared with dual-hormone artificial pancreas and p=0·32 compared with single-hormone artificial pancreas). 15 hypoglycaemic events (<3·1 mmol/L for 20 min measured by sensor then confirmed with capillary glucose <4·0 mmol/L) were noted during nights with conventional pump therapy compared with four events with the single-hormone system and no events with the dual-hormone system. None of the assessed outcomes varied with the order in which children and young adults were assigned interventions.

Interpretation

The dual-hormone artificial pancreas could improve nocturnal glucose control in children and adolescents with type 1 diabetes. Longer and larger outpatient studies are now needed.

Haidar A, Legault L, Matteau-Pelletier L, et al. Outpatient overnight glucose control with dual-hormone artificial pancreas, single-hormone artificial pancreas, or conventional insulin pump therapy in children and adolescents with type 1 diabetes: an open-label, randomised controlled trial. Lancet Diabetes Endocrinol. 2015;3(8):595-604."

To RPHs want to learn about new research progress for Parkinson’s, Alzheimer’s, and Amyotrophic Lateral Sclerosis (ALS) Sign up at the link below.


https://www.labroots.com/ms/webinar/id/154/axion-oct7# WEBINAR: Advancing neuroscience: functional insights from in vitro microelectrode arrays

Abstract

DATE: October 7th, 2015
TIME: 9am Pacific time, 12pm Eastern time

The neuroscience field is rapidly evolving as both a burgeoning area for basic research (Parkinson’s, Alzheimer’s, Amyotrophic Lateral Sclerosis (ALS) to name just a few) and as a focus area for commercial therapeutics.  However, research and drug discovery in this field is often hindered by the low-throughput of many of the established techniques.  In addition, many of the common assays used require advanced expertise and are quite costly. 

Enter the microelectrode array (MEA) and the Maestro platform from Axion BioSystems:  a simple approach to measuring complex, functional neural responses at the throughput level you need.  Together with integrated control software, the Maestro makes acquisition and analysis of neural networks accessible, straightforward, and scalable up to 96 wells.

After a brief introduction to MEA technology, we will showcase two examples of successful implementation of the Maestro platform into neuroscience research and discovery programs. Then your patient will go from this
 to this

Breaking... for the cancer patient

FDA approves Keytruda for advanced non-small cell lung cancer10/02/2015 01:50 PM EDTThe U.S. Food and Drug Administration today granted accelerated approval for Keytruda (pembrolizumab) to treat patients with advanced (metastatic) non-small cell lung cancer (NSCLC) whose disease has progressed after other treatments and with tumors that express a protein called PD-L1. Keytruda is approved for use with a companion diagnostic, the PD-L1 IHC 22C3 pharmDx test, the first test designed to detect PD-L1 expression in non-small cell lung tumors.

Source: FDA.gov

From RPH On The Go

"Happy American Pharmacists Month!

This month especially, you should walk with your head held high and be proud of everything you do. Ensuring proper medication use and safety for the American public is a vital part of our healthcare system—something that shouldn't be taken for granted. And that's exactly what this month is about—celebrating pharmacists.

If you're celebrating in a big way, earning some recognition or hosting an event, let us know by tweeting us @RPhOnTheGo or by posting on our Facebook page. We'd love to hear from you"