Showing posts with label 心灵药剂. Show all posts
Showing posts with label 心灵药剂. Show all posts

Friday, February 26, 2016

Virus is more scary than Bacteria nowadays?

While we are struggling to deal with the resistant BACTERIA here, those deadly VIRUS are approaching us from behind.... HIV has killed billions of people; Ebola is just being announced clear last year; and now Zika, which we still don't have any cure or way to control it. Scientists are worried about the possibility of transmission among human. We haven't really handle the Bacteria well, and now are we ready for the Virus?

(Adapted from Bacteria vs. Viruses by Audrey Best)


Saturday, April 18, 2015

"Ezetimibe and Vytorin are just marketing tools, a way to evergreen the patent on Zocor." Ezetimibe might be nothing more than placebos??

Again, big pharmaceutical companies cause patients and prescribers to lose confidence on their drugs with unconvincing studies data....

The excerpt below taken from Forbes by Matthew Herper-


"..... Merck and Schering behaved terribly when developing ezetimibe: burying data, heavily marketing the drug with television ads, and paying some doctors to talk it up. From the start, the companies dragged their heels on starting a study to test whether or not adding ezetimibe to a statin prevented heart attacks and strokes. Such a study didn’t begin until 2005, a year after the drug was approved.

Critics saw the whole ezetimibe franchise – both Zetia and Vytorin – as a cheap trick to extend the life of Merck’s $7-billion-a-year Zocor, which would lose patent protection in 2006. The ezetimibe pills would have another decade of patent protection. When Vytorin, an ezetimibe-Zocor combination, was approved in 2005, Steven Nissen of the Cleveland called it “a step backward.” He added: “There is not enough evidence to justify putting millions of Americans on a statin-sparing medicine. Ezetimibe and Vytorin are just marketing tools, a way to evergreen the patent on Zocor.”

"...... I found Merck and Schering’s response to the controversy infuriating. As one top cardiologist after another advised that patients shouldn’t get ezetimibe unless they couldn’t take a higher dose of a statin because of muscle aches or other side effects, the companies just seemed to keep insisting their own data was meaningless. I remember Merck PR people pushing me hard to interview Antonio Gotto, the dean of Cornell-Weill Medical School, whose views on ezetimibe seemed far more positive than anyone else I spoke to. According to investigators for Senator Charles Grassley, Merck paid him $27,146 for lectures and consulting during that five-month period.

But once this negative narrative was set, there was a tendency for ezetimibe to look even worse than it was. It became the poster-drug for not gathering enough information about a medicine before marketing it. When more patients taking Vytorin got cancer than those taking placebo, it was easy to find critics who were worried about the connection. Scientists working with Merck misplayed their hand by trying to insist that there was absolutely no risk, creating a scary-sounding debate about whether the cancer link was unlikely or completely impossible."

"..... The questions this begs: should I think about taking ezetimibe myself? I eat broccoli and take the stairs. But my cholesterol has sometimes tended to be high– though I’ve lately kept my LDL around 100 with a combination of exercise and a healthy diet rich in nuts and olive oil. If I started taking Zetia now, lowering my cholesterol further, would it decrease my risk of a heart attack or stroke over decades? We don’t know but the prospect is tantalizing.

For years, many cardiologists have been arguing that we might be able to eliminate heart disease if we could get our cholesterol down to the levels seen in hunter-gatherers. Even very healthy diets do not do this. A daily ezetimibe might — but we don’t have the data to prove it would. What would doctors say to patients who suggested it?

“The FDA has not approved it for anything like what you’re suggesting,” says Braunwald. “But you know in medical practice you sometimes have to go by the best evidence that’s around. Just recognizing the fact that the FDA hasn’t approved it for these purposes, I would certainly strongly consider it.”

There’s a big counter-argument. The study of ezetimibe from last fall – the only real test of the drug that Merck deigned to do – was in heart patients, not healthy people. Nissen, the longtime Vytorin critic, proposed a different solution to me if I insisted on being a one-person cholesterol-drug experiment: take a half-dose of the well-proven statin Pravachol, which has a great safety record and has been much more thoroughly studied. Most likely I’ll do what I always do when there’s conflicting medical evidence and I’m in no immediate peril: nothing."

The hardest thing about medicine – and about writing about it – is admitting that we don’t know what we don’t know. At some point, doctors and patients have to assemble all the evidence they can, make their best guesses as to why to do, and take leaps of faith. All we can do is collect more data and make the leaps a bit smaller.

Thursday, July 3, 2014

Friday, April 2, 2010

Truth about Pharmacists Job

When I first entered university, I liked to ask this question to my course mates, "Why do u choose pharmacy?" The answers vary- "I want to get rich", that's the most common answer; "I don't want to study medic but I like biology", second common; "Girls not suitable to be engineers, so choosing pharmacy instead, as I was studying physics", third common; other answers like friends influence, parents influence are available too. Then, after I graduated, I ask this question to the to-be pharmacists and pharmacists, "Do u really wanted to choose pharmacy in the first place?" Guess what? Most of the answers are "I was being cheated!!!" together with a sad and regretful face...

All these happens because we don't know the actual role of pharmacists and what kind of job a pharmacist really is. What we see is pharmacists outside there are rich, with big house and great car, relax life as they only open their shops at 10am. If choose based on subjects studied in pre-U, then pharmacy is the option if not choosing medic, thinking that pharmacy is just like medic without the surgery. Then the regret comes when we realized all of the view of pharmacists we have all the time is WRONG! This is not the job we want! This is not our interests! Then the struggle is stronger when being told that we have to do compulsory services and our working place have to reshuffle again after one year... What? We are not being told all of these before!!! Then here comes the statement, "If I know that earlier...." and so the regret adding more and more even until we become a pharmacist now.

People thought that pharmacist is a wonderful job dealing with doctors where everybody proud of... or pharmacist is those who open a shop and sitting there acting like a doctor; or just a person who sits at counter giving out medicine where a nurse can do it, so pharmacist is not needed at all...

No! Let me tell u who is a pharmacist...
There are pharmacists who deal with doctors and patients only - clinical pharmacist;
pharmacist who are 'rich and relax' - community or retail pharmacist;
pharmacist who deal with paper works, machine and quality of medicine - industrial pharmacist;
pharmacist who carries law books and do raiding - enforcement pharmacist;
pharmacists who deal with patients, nurses and medicines - outpatient and inpatient pharmacists;
pharmacists who deal with stocks and sales rep - store pharmacists;
pharmacists who handle chemotherapy (cancer) medicines - cytotoxic drug pharmacists;
pharmacists who deal with blood and reading - TDM pharmacist;
pharmacists who handle injectable nutritional solutions - TPN pharmacist;
pharmacists who deal with radioactive substances - radiopharmacist
what else I have not included yet?

The above are the kind of job a pharmacist can do... then let me tell u what do a hospital pharmacist do...
1) Answer telephone (info request, on-call, complaints, etc...)
2) Calling the ward and doctors, medicine companies and sales rep (also a telephone job)
3) Calling to other hospitals (borrowing medicines...)
4) Searching medicine information
5) Filling and dispense medicines
6) Finding doctor's errors (That's the reason doctors and pharmacists always in quarrel)
7) Check stock
8) Merchandising (first-in-first-out rule, just like in department store)
9) Copying patient bed tickets (instead of reviewing)
10) Mixing syrup (just like making coffee and milk)
11) Calculating (dose and TDM work)
12) Filling forms
13) Counselling patients
14) Decorating??? (For the 5S things)
15) Doing presentations and research

hmm.... Do I miss out anything? So, a pharmacist is a manager? a businessman? a telephone operator? a walking computer? a clerk? a store keeper? a counsellor? a researcher?
Sometimes even an entertainer? Because some patients like to scold pharmacists when they are waiting for too long, so its the chance for us to entertain the patients... We are not deal with medicines only, neither patients only. In short, a pharmacist is a multi-role job where I also can't find a word to define it.

How about the life of a pharmacist in government sector? Well, it is a "punch card" life... Every morning drag a reluctant soul to punch card before 8am then hoping don't have to meet any stubborn and 'aggressive' patients and doctors, waiting for 1pm to have lunch break, then waiting for 5pm to punch card again... During on-call time, praying for the phone not to ring, praying for a good sleep without disturbing of phone calls... haha... Quite boring and dry lifestyle huh...

But things will change. Try to put aside the regret and think. As we working, we acquire knowledge and collect experiences, as time goes by, we'll build up our confidence as a real multi-purpose pharmacist!

So, these are the truths that no outsiders will know except u work as a hospital pharmacists before... Therefore, to the students who wish to choose pharmacy, make sure u really interview a hospital pharmacist first; to the doctors, do understand us and not blame us all the time; to the public, do appreciate us after receiving your medicines as all the medicines u received are free of charge, so stop complaining!

Saturday, October 10, 2009

新的人生旅程

当初还很天真的告诉自己得到哪里都会接受,却到了最后关头,才苦苦哀求希望得到最靠近家里的医院。当初也很天真的告诉自己希望去一个陌生的地方,重头来过,过新的生活。现在才尝到人生地不熟的痛苦。独自一个人来到了Hospital Kulim, 没有朋友,只好硬挤出笑容来面对每个人,其实心里是一直忐忑不安,担心自己将会面对怎样的挑战。

总算,千辛万苦过了一个星期。到了周末的那一刻,还真是有点小激动的快乐。医院的服务讲求速度和素质。在outpatient 部门,手上拿着15个药的prescription, 一心想达到快速度和高素质,还真的是困难。加上数学白痴的我,要算每一种药一个月的supply还真是费了我不少功夫。算着insulin的unit, 站在冰箱前大半天,都算不出一个月要给多少支的insulin, penolong farmasi 在一旁看我惊慌的样子,他都不需要20秒的时间就算到了……还有明明同样的药拿了几次,却总是忘记它的位置。我还真是善忘。想要快的时候,却拿错了dose……当面对这样的情况时,要我在病人面前挤出笑容来dispense,简直就做不到。

一直忙到lunch time, 自己没有车,又人生地不熟,有同事愿意载,已经是很好了。又怕人家等太久,又匆忙把手头上的工作做完,跟大家出去吃饭。这时候,要我在同事前脸带笑容,也是很勉强的事。一向不擅交际的我,吃饭时间只好静静吃饭,坐在一旁听senior PRP 们高谈阔论。

放工了,幸好还回到自己熟悉的家,熟悉的房间,熟悉的冲凉房,洗了热澡,还有我熟悉的 laptop上网。到了晚上,那些在工作时隐藏的疲累,都接踵而来。这时连MSN都懒得 sign in了。身为 PRP, 竟然要记录每天所作的事情,要给preceptor 看,回来还要伤脑筋,怎样写才能让preceptor 满意,这简直是虐待……

到了周末,总算有得睡得比较迟。想到晚上又要上吉他课,练了两个星期的 F chord 还弹不出来,还真的觉得自己不够上进。到了课室,幸好今天教《隐形的翅膀》,是我熟悉的激励歌曲,这星期才算满意收场。音乐始终是让我放松的好帮手,看来我要多靠靠“音乐”这家伙了。

明天就开始正式posting, 在ward supply 部门,也是个不能放松,和讲究速度和素质的地方,看来我又有气要受了……

Saturday, September 5, 2009

When Health Care Gets Ugly - Pfizer to Pay $2.3 Billion for Fraudulent Marketing of Bextra-

Health care should be a field that gains the trust of the public for better quality of life. However, when comes to the line between ethics and profits, people tend to become greedy... money is the thing they choose in the end and people lives being put in danger...

Here's the excerpt of the news...

"WASHINGTON – American pharmaceutical giant Pfizer have agreed to pay $2.3 billion, the largest health care fraud settlement in the history of the Department of Justice, to resolve criminal and civil liability arising from the illegal promotion of certain pharmaceutical products..."

"...a felony violation of the Food, Drug and Cosmetic Act for misbranding Bextra with the intent to defraud or mislead. Bextra is an anti-inflammatory drug that Pfizer pulled from the market in 2005..."

"In addition, Pfizer has agreed to pay $1 billion to resolve allegations under the civil False Claims Act that the company illegally promoted four drugs – Bextra; Geodon, an anti-psychotic drug; Zyvox, an antibiotic; and Lyrica, an anti-epileptic drug – and caused false claims to be submitted to government health care programs for uses that were not medically accepted indication..."

"Illegal conduct and fraud by pharmaceutical companies puts the public health at risk, corrupts medical decisions by health care providers, and costs the government billions of dollars," said Tony West, Assistant Attorney General for the Civil Division."
(Full text of news here)

From another website, here's the excerpt...

"The FDA rejected a company application to market the drug for uses like that because the benefits didn't outweigh the risks, mainly cardiovascular problems. Bextra was approved to relieve arthritis pain (10 milligrams once a day) and menstrual pain (20 milligrams twice a day). But Pfizer touted Bextra heavily for other conditions and at higher doses anyway..."

"...encouraging doctors to start patients at high doses of Bextra--eight times the approved starting dose in the case of migraine patients..."
(Full text here)

Sunday, June 28, 2009

讲座会

今天去听了个关于抗癌草药的讲座会 - “天仙液”。孙医师在讲解癌症病发的过程时,我听了都很明白。

当初,我一直质疑自己是否读错科,一直以为自己比较适合文科。今天,当我可以完全明白一个专业人士所表达的讯息时,才觉得读了四年的药剂都没白费。觉得自己应该珍惜那所学得的知识,来帮助身边的人,而停止埋怨药剂不适合我,更应停止彷徨和忧虑,到底哪个领域才真正适合我。走过的岁月无法挽回,自己所拥有的一技之长,才是一生的宝藏。既然我学了多年的科学,就更不应该搁在一旁。其他领域或许可当兴趣,一并学习,其间更应钻研属于我专门的知识。

科技越进步,人们却越往传统药方寻求治疗,这不是很矛盾吗?先进的医疗不足以满足人们的需求,人们反而寻究根本,从最基本的饮食开始改善身体新陈代谢。近期越来越多专业人士作了草药方面的研究,证明比一般西药来得安全,效果更好。大家在使用传统药方之前,请别盲目接受,请咨询专业人士的劝告。别忘了,在市场上有很多假药哦!