Shocked And Humiliated. People Say The Meanest Things.

So as part of the deal I've made with myself to prevent the onset of full-fledged alcoholism, I only let myself buy scotch out of funds designated as "overtime" on my pay stub. Mostly because working the occasional OT shift gets me out of my darkened room where I sit and listen to Wagner while softly cursing Jennifer Aniston for starting the flat hair craze. I miss 80's hair.

This morning I show up at a store where I pick up some of these OT shifts from time to time. "Oh I'm glad you're here." The tech said as I struggled to remember my password. I should have known this was the first sign of trouble.

"And why do you say that?"

"The other pharmacist is mean"

"No, I think you're confused. I'm mean."

"Seriously, that other guy is rude. The customers hate him and it's hard to work like that."

You have no idea how much it hurt to hear these words. Why didn't these people just insult my mother?

I decide to show them who the drugnazi was. Next customer that came in got the silent treatment. What does he tell the clerk?

"That guy always gets my pills out fast. You should hire him full time"

DAMN YOU! CAN'T YOU SEE I FIND YOU BENEATH CONTEMPT? ARE YOU SO INCREDIBLY STUPID AS TO NOT SEE THE REASON YOU GOT YOUR ZYPREXA SO DAMN FAST WAS BECAUSE I CAN'T STAND TO SEE OR SMELL YOU?

A quick aside. Anytime anyone, anywhere, has ever told me I was a "good" pharmacist, what they have meant was that I was a "fast" pharmacist. No one has ever said to me "no pharmacist knows drugs that are responsible for CYP3A4 induction interactions the way you do drugnazi" and no one ever will.

Later on in the day an old lady brought in cookies. A drugnazi eating old lady cookies. Jesus I'm glad this is an anonymous blog. They were good.

After work a guy from the gas company showed up to light the pilot light for my fireplace. The pilot light wasn't the problem. The electric igniter had been unplugged before I left for vacation in June and I had forgotten about it. Where's the fucking scotch? I earned it today.

The Lady At The Pizza Place Gave Me A Free Soda Today

I wonder if she was hitting on me? I wouldn't blame her, 'cause I am kinda hot. Some have said I bear an uncanny resemblance to the Italian chemist Amedeo Avogadro.

On the other hand, it looked like she had already rung up my total, and adding a soda was more work than she was interested in.

I have long said that the three forces that rule the world are laziness, money, and incompetence. These three words explain 99.98% of human actions.

Since the second explanation fits into the "3 forces" rule, it's the one I'll have to go with.......dammit.

I Issue A Challenge To Your Doctor, Drug Companies, And The Entire World.

Give me one good reason Proquin XR should exist.

Just one reason this piece of crap should be taking up any space on my shelf.

"To fatten the profits of Depomed and Esprit Pharma" doesn't count. I said a good reason.

If you can do it, I will sign over my next paycheck to you.

First some background as to why I am so confident you will never lay a hand on my money. Proquin XR is an extended-release version of the antibiotic ciprofloxacin, which has been around for years and is now available as a generic. It's not unusual for a "cr" "xr" or "xl" version of a drug to come out just as the original is losing it's patent protection. The rationale you'll hear from Drug Companies is that by making a longer acting version of a drug, they're increasing the effectiveness of therapy by making it more likely the patient will remember to take their meds as they should. Fine. Put aside the fact that the price the patient pays for being a lazy ass is almost always completely out of proportion to the benefit. At least you can argue there is a benefit.

Thing is, ciprofloxacin has had a profit-enhancing more convenient to take form for awhile now. For those of you who can't handle taking a tablet every 12 hours and are willing to pay up, there is Cipro XR. The once a day convenience will add about 55% to the cost of treating your urinary tract infection. Worth it to someone I suppose. I've learned never to underestimate the more money than brains demographic.

Now along comes Proquin XR. The name "Proquin" comes from the Latin words "pro," which means "for" and "quin," which means "no apparent reason" Proquin is an extended release form of ciprofloxacin, just like Cipro XR, and you take it once a day, just like Cipro XR. There are some very important differences between Proquin and Cipro XR though:

1) The official labeling of Proquin advises patients to take it with food. This allows them to claim that when taken as directed it has a lower incidence of GI side effects than Cipro XR or generic ciprofloxacin.

2) It costs 38% more than Cipro XR, and 114% more than generic ciprofloxacin. (all prices come from my place of employment)

3) The tablets are a very attractive shade of blue, as opposed to the ciprofloxacin's rather boring off-white.

The most important difference of all though is the particular extended-release mechanism used by Proquin. Since it is different from Cipro XR's mechanism, it means that the two products are not exactly the same, and therefore not substitutable by me unless I call your doctor. Which I won't. I call your doctor when he or she's doing something that might hurt or kill you, not when he's or she is wasting money. This will be the only warning you get. Use it well.

Today I Use Pop Psychology To Analyze Drug Names

I don't remember a lot about college really. I remember my organic chemistry professor telling us that car tires are much better today because of the wonder of modern polymers. I remember Avogadro's number, 6 x 10 to the 23rd power, is the number of atoms in an element's atomic weight in grams. Many a time as graduation neared the question "what is the most common side effect of Drug X?" would produce a doe-eyed silent stare in the young drug nazi, but I remembered Avogadro's number long after it's moment of extremely limited use had faded into the dustbin of my academic history.

I also remember discussing in a pharmacy marketing class the topic of drug names. Not the boring generic names, which are picked by a chimpanzee throwing darts at a poster of the alphabet, but the snazzy, hip, we want to make you feel good about spending your food budget on this brand names. I remember the professor telling us that a drug company would spend in the six figures figuring out what to call a product, chasing the perfect combination of letters that would maximize sales without doing something like sounding like the Chinese phrase for "fuck your mother." He told us that "power letters" such as X and Z were the way to go, and the evidence at the time bore him out, as the free drug pens we were using in class would have been for manly-sounding, powerful names. Xanax, Zantac, Effexor, Zyprexa, Zyrtec, Xenical. These meds were gonna kick the ass of whatever ailed you.

It would seem times have changed. Here are a few names plucked from a list of new drugs approved by the FDA in 2006:

Atripla
Emtriva
Prezista
Opana
Oracea
Daytrana
Relenza
Amitiza
Ranexa
Boniva
Climara

And of course my personal favorite, Exubera, which I think is the Latin word for bong.

Our drug names have gone flaccid. Obviously, there's a focus group out there that has managed to convince Big Pharma that feminine sounding three or four syllable words that end with "A" are the way to go. The question is, why? I thought about it some and came up with a theory. The great thing about a theory is that you don't need a shred of evidence to support it. So here is my theory, which has yet to be proven wrong:

After 15 years of the press, usually in the business section and with the main angle being how much money it would cost the manufacturer, running stories about drugs such as Rezulin, Baycol, Bextra, Vioxx, Duract, Posicor, Propulsid, Tequin, Redux, and Seldane injuring and/or killing people and having to be pulled from the market, Big Pharma was worried that people might be starting to realize that prescription medicines could be dangerous. A newly-hired 25 year old marketer proposed that the way to solve this problem was to make the drugs less dangerous and was immediately given a new position cleaning up poop in the room where they keep the dart throwing chimpanzees. The current vice-president of international marketing of Big Pharma Inc, was the man who proposed dealing with dangerous chemicals by giving them less dangerous sounding names.

"Vioxx" = Scary. RUN!

"Atripla." What could something called Atripla possibly do to hurt you? Now hand over your $75 copay and feel safe......you are getting sleeeeeeepppppyyyyy...remember Atripla is your friend.....a good, trusted friend.......

I also think it might have something to do with Avogadro's number. I'll theorize some more and get back to you on that.

This Has Nothing To Do With Drugs Or Work, But It Is Another Reason To Hate Republicans.

If you're old enough, you might remember how Ronald Reagan mopped the floor with Jimmy Carter during a presidential debate by telling the American people to ask themselves a simple question, "Are you better off than you were four years ago?" He was implying that Carter wasn't fit to be president because the state of the American economy under his leadership was hurting the average citizen. Now here's a map showing the change in median income in each state during the last six years from The Detroit Free Press, via The Washington Monthly:


Just in case you needed another reason why Monkey-Boy isn't fit to be your president.

Oregon Joins California In The Axis Of Irresponsibility, Takers Of Paxil CR Fear For Their Mental Health.

In the Golden State, we saw how politicians desperate for votes can break free of corporate influence for a few days to help sick people. From the Beaver State (huh huh.....huh huh.....beaver) comes word today of the people themselves going around a legislature still under the corporate heel and taking direct action. From The Seattle Post-Intelligencer:

A measure to make prescription drugs more affordable for Oregonians without health insurance or drug coverage appears to be one of the few initiatives on the November ballot -- and perhaps the only one -- with little controversy or opposition

Measure 44, sponsored by state Sen. Bill Morrisette, D-Springfield, grew out of attempts in the 2005 Legislature to expand a discount program allowing the state to buy prescription drugs in bulk for low-income seniors without drug coverage, and for school districts and local governments.

Opposition from pharmaceutical industry lobbyists killed the expansion effort last year, so Morrisette turned to the initiative process.

No matter what the means for getting there, it would seem there is a movement amongst the people to figuratively kick Big Pharma in the nads. Whoo Hoo! The Pharmaceutical Research and Manufacturers of America, the trade group of the pharmaceutical industry, knowing it can't stop the initiative, has been reduced to limiting the plan to cover only individuals and not private employers. Still pretty shitty of them, but nowhere near the pure evil we've come to expect from their ilk.

So today the drugnazi takes a few minutes to say "yay for us" and raise a bit of scotch aloft in celebration before it goes into my stomach. Tomorrow I return to watching my back.

California Recklessly Puts The Future Of Breakthroughs Like Paxil CR At Risk

It would seem the Golden State has witnessed a remarkable political transformation. In less than a year, the Governor, known to millions the world over as a time traveling killer robot, has changed his top priorities from Union Busting and starving state government of revenue to limiting greenhouse gases and using the power of state government to help California citizens afford their prescription drugs. According to the LA Times:

The price-reduction effort, a showpiece for Schwarzenegger's reelection campaign, is an approach he rejected last year and one opposed by the drug industry

An approach he rejected last year, when he wasn't running for re-election. Might those two things be related? I'll let you decide. I suppose though I would rather have someone in office who talks sense for 6 months out of his term than the fatal stubborn arrogance of president monkey-boy. And at least the state government of California hasn't declared war on cursive handwriting.

According to the Times, the plan:

would give the drug industry three years to voluntarily negotiate discounts with the state on behalf of people who earn up to triple the federal poverty level, or about $60,000 a year for a family of four. An additional 400,000 people who earn somewhat more but face debilitating medical bills also would be eligible.The discounts would take as much as 40% off brand-name drugs and up to 60% off generic medicines.In a major concession, Schwarzenegger agreed that companies that offer insufficient markdowns could be impeded from selling drugs through Medi-Cal, a $2-billion market that serves millions of Californians.

Big Pharma is ecstatic. The article goes on to quote the CEO of Pfizer, who says that "We've been ripping off consumers for far too long, and are thankful that Governor Schwarzenegger and the legislature have put an end to our unethical price gouging." Then he held a press conference where he set fire to a giant symbolic check made out for 3.9 million dollars, an amount equal to his bonus for 2005.

OK, I made that last paragraph up. Except for the amount of Pfizer's CEO's bonus. I'll bet I don't have to tell you what Big Pharma's real reaction was. It's the same tired argument we've been hearing year after year. Namely, as the Corporate whore of journalism, The Wall Street Journal, puts it on it's editorial page:

Over the long term, Gov. Schwarzenegger's price controls would have an even more perverse effect. They would lead to fewer new medicines, particularly if other states follow California's example.

Today, it costs between $800 million and $1 billion to bring a new drug to market.

Except that there are fewer medicines being developed now. From Forbes, not exactly a center for left-wing muckraking:

A total of 87 major drugs with $31 billion in combined annual sales have lost patent protection since 2002, but new drugs aren't arriving fast enough to replace them. Only 20 were cleared by the Food & Drug Administration last year, down from 53 a decade ago.

Makes you wonder what Drug Companies are doing with the gusher of dollars our current unregulated system is sending into their coffers. Other than writing 4 million dollar checks to their CEO's, they're stopping research on antibiotics while spending $84 billion a year doing things like convincing us we have diseases they invented that match drugs they already have on the market. OK, to be fair, they probably aren't actually writing out 4 million dollar checks. The CEO of Pfizer more than likely has direct deposit.

The $84 billion falls under the category of "marketing and administration." It's over twice what Big Pharma spends on research, and according to their own propaganda, it's enough to bring 84 new drugs to market each and every year. Except the new drugs aren't happening.


So if we're going to get less in they way of new drugs that actually cure disease, we might as well pay less. I'd never thought I'd say this, but yay for California state government. Just watch your back after election day.

Five Years Of Pharmacy School, And These Are The Questions I Am Asked.

Three quick hits of wisdom from today's pill filling fest:

1) "If I bring in a new prescription, can you fill it?"

Yes. Yes we can. That's what we do.

2) "This pad days 8 by 10 and this one says 5 by 8. Why is this one in a smaller box?"

Just please fucking kill me.

3) "I need my cholesterol medicine, the one that starts with an 'L'

"Would that be the Zetia?"

"Yeah, that's it"

For some reason that one didn't bother me. I don't know why.

You Know, Thanks But No Thanks.

Alternate Post Title: One More Reason Your Prescription Takes So Damn Long To Fill.

Jesus Christ. With people doing me favors like this I have no need to fear one of the ex-girlfriends showing up to put a knife in my brain. From the trade publication Drug Topics:

Washington State pharmacists are wondering if they are expected to be the penmanship police since a new law decrees that prescriptions in cursive handwriting are no longer considered to be legible.

As of June 7, legible Rxs are defined as hand printed, typed, or electronically generated, said Steven Saxe, executive director, Washington State Board of Pharmacy. Even if an Rx written in cursive handwriting is perfectly readable, it is still not considered to be legible, and pharmacists must act accordingly.

Look numbnuts, there are very few things that piss me off more than a Dr. Dumbass who seems to be incapable of communicating in the written form of any of the world's languages despite having a graduate degree, but I'm the one filling the damn prescription, which means whether it's legible or not is up to me. If I know what the doctor wants you to have, it's legible, if I don't, then I call Doctor Dumbass and find out. Do you seriously think you can solve this problem by making me call not only Dr. Dumbass, but every other doctor on the face of the earth to "verify" every single prescription where letters are connected together? Does doing something like this make you feel important in some way? Is there seriously nothing more worthy of your attention going on in Washington state? In other words....... WHAT IN THE FUCK WERE YOU THINKING????!!!!!!

Listen to me buttwipes. I can barely keep up with the vast pill craving hoards of barbarians as it is, so you try something like this in my state, and I will defy you. You got that? I will most assuredly and purposefully break any stupid-ass clone of this law you may get the bright idea to waste your and my time on. Then you can take me to jail. Then no prescriptions get filled at all. How you like those apples?

Fuckers.

Thank God For The Alert Passer By

It was a busy day. The kind of day when you're happy to have to take a dump because it means you get to sit down for a couple minutes. Those of you in the profession know exactly what I mean.

In the midst of pill-counting chaos though, an eerie kind of quiet settled over the pharmacy. It was kinda nice at first, until I noticed the intern making heaving type motions like a cat about to toss up a hairball, trying to talk and unable to make a sound. Now I hate to touch people, but it was really looking like I was going to have to go over and take a shot at the Heimlich maneuver. At this very moment one of our regular customers walks by, says,

"her face turns as red as her hair"

and continues her shopping trip down the aisle. Part of me now wants to go out and kick the customer in the crotch. Since the customer was a woman, making a crotch kick of little value, I instead turn my attention to the dying intern.

I am happy to report that the intern spat out a piece of drug rep candy, everyone lived, and I had to touch no one.