Filed under: General Problems | 8 Comments »
A recent study found steroid injections for a common condition could be causing more harm than good
Posted on June 29, 2020 by Pharmaciststeve
some chain pharmacy generating business by making sick employees to keep on working ?
Posted on June 29, 2020 by Pharmaciststeve
Hello there, I’m reaching out to you because I feel that there is seriously something wrong with Walgreens right now. I wish to remain anonymous please.
I’m in the DFW area and as you may already know, Texas has had a huge surge of COVID-19 cases. Saturday night, I had 3 of my techs coming down with symptoms. I asked Walgreens what to do? “Go see their primary care doctor and pharmacy stays open.” Is there a way to get them fast tracked for testing? “They need to see their primary care doctor first.” With how my tech’s symptoms are and THREE of down coming down with the same symptoms at the same time, I am positive that it is COVID19 yet Walgreens has refused to do anything. No doctors are going to be open on the weekend for such late notice COVID testing. Walgreens will not close the pharmacy, they will not do a deep cleaning, they do not allow us that extra time to clean before and after closing. I’m so tight on hours that if I have my techs stay after closing to clean, I would be over my budget. I’m really damned if I do damned if I don’t. I had to advise my other techs to make an appointment at CVS to get themselves tested for COVID because it takes 2-3 days to make an appointment. Isn’t that sad? As Walgreens employees we have to go to CVS to get tested. My worst fear is, there is a technician at another store who tested positive, that Walgreens still is operating like normal. Nothing was done. Walgreens does not care about its customers nor their employees by pretending that there’s nothing wrong when there is a positive COVID case. I feel like we need to call out this behavior because it really is detrimental to our community as a whole. Who knows how many other Walgreens is doing this?
Filed under: General Problems | 2 Comments »
The Rapp Report – Dr Thomas Kline
Posted on June 29, 2020 by Pharmaciststeve
https://therappreportpodcast.podbean.com/e/e12-interview-with-dr-thomas-kline-md
In this episode, we interview Thomas Kline, MD.
Dr. Kline lives in Raleigh, in the Great State of North Carolina. He not only treats patients suffering with chronic pain, but also advocates for them. Many of whom rely on opioid analgesics to survive.
He has more than 40 years experience with long-term diseases, and has a very distinguished resume, including as the former Chief of Hospital in Home Service at Harvard Medical, a physician at Boston Children’s Hospital, his MD from The University of Maryland, completed his residency at the distinguished Stanford University, and he also has a PhD from The University of Oregon.
Dr. Kline has also authored several publications, been quoted in various medical articles, has been a guest on the Roy Green Radio Show, and is featured in a number of YouTube videos.
These can be found at https://thomasklinemd.com/
He is also on JATH Educational Consortium at https://www.jatheducational.com/
Opioids in America: Misconceptions and Misperceptions https://www.youtube.com/watch?v=qJZOqbbro-8
Any questions for Dr. Kline? You can reach him via email at thomasklinemd@gmail.com
Filed under: General Problems | Leave a Comment »
FDA names five companies recalling NDMA-contaminated metformin
Posted on June 27, 2020 by Pharmaciststeve
FDA names five companies recalling NDMA-contaminated metformin
The US Food and Drug Administration (FDA) announced on Thursday that five companies have now voluntarily recalled extended-release metformin drugs because of elevated levels of N-nitrosodimethylamine (NDMA), a potential carcinogen.
The five companies who were notified of the agency’s testing results and who are recalling their extended-release (ER) product, and specific labeling and lots recalled, are:
- Apotex – all lots
- Amneal – all lots
- Marksans, branded as Time-Cap – one lot (XP9004)
- Lupin – one lot (G901203)
- Teva, branded as Actavis – 14 lots
There are additional companies that manufacture ER metformin and supply a significant portion of the US market, whose products are not being recalled at this time,” said FDA. Immediate release metformin formulations have not contained NDMA in the FDA’s testing thus far. The substance is ingested in low levels through normal dietary pathways but can raise the risk of cancer with long-term elevated exposure.
(RELATED: FDA recalls some ER metformin for NDMA impurity, Regulatory Focus 29 May 2020)
The agency has now posted updated results of its NDMA testing in a sortable tabular format that includes all companies whose product has been tested, which formulations and lots were tested, and what levels, if any, of NDMA were found.
A second testing method using liquid chromatography-electrospray ionization-high resolution mass spectrometry has been posted by the FDA “to provide an option for regulators and industry to detect eight different nitrosamine impurities in metformin drug substances and drug products,” said the agency.
Companies manufacturing ER metformin should evaluate the risk that it contains NDMA at elevated levels. Companies should conduct per-batch testing, notify the FDA of any test results showing NDMA above the acceptable intake limit, and not release that batch to the US market.
Filed under: General Problems | Leave a Comment »
EVERY AMERICAN SHOULD SEE THIS VIDEO. IT SUMS UP BEAUTIFULLY HOW CORRUPT OUR CONGRESS IS!
Posted on June 26, 2020 by Pharmaciststeve
Filed under: General Problems | 3 Comments »
Which agency is the least efficient .. DEA or IRS ?
Posted on June 25, 2020 by Pharmaciststeve
IRS spent millions on audits that returned no revenue, report finds
About half of large business returns audited were closed without change
The IRS is wasting time paying employees to audit returns that generate no additional revenue for the agency, a watchdog report released Thursday found.
Of the 10,755 returns that were analyzed – and closed – during fiscal years 2015 through 2018, a report by the Treasury Inspector General for Tax Administration found that 47.2 percent were closed with no change to the return. The agency estimated that – accounting for the costs of examining the returns – about $22.7 million was spent on these returns, which generated no additional revenue for the government.
These returns were examined in the IRS’ large business and international audit group, which is responsible for the tax administration of domestic and foreign businesses with assets exceeding $10 million.
Among these businesses with assets over $10 million, the no-change rate of returns examined ranged from 44 percent to 66 percent across all total asset amount ranges. Theoretically, there should be a lower no-change rate for categories of businesses and individuals with a higher risk of noncompliance, which TIGTA largely did not observe from the data.
The division’s closure rate was also 37 percent lower in fiscal 2018 when compared with fiscal 2015, according to the report, which was attributed to a decline in employees.
TIGTA suggested the division could better allocate its time and resources, spending less time on “no-change work.” It also said that due to the evolving nature of the business environment – including the implementation of the Tax Cuts and Jobs Act and an expanded use of virtual currency – the group needs to update its formula to better identify companies that are at higher risk of noncompliance.
In a response to the report, the IRS said it did not agree with the watchdog group’s monetary estimates based on the hours it assumed workers spent on no-change work. It also did not agree with some of the recommended policy changes.
The IRS estimates the average annual gross tax gap for tax years 2011 through 2013 is $411 billion, with the largest percentage stemming from under reporting
Filed under: General Problems | Leave a Comment »
Former DEA task force agent ..” spills the beans” about the war on drugs
Posted on June 25, 2020 by Pharmaciststeve
Russell Jones has been involved in the “War on Drugs” on various fronts for more than 40 years. For 10 of those years, Russell worked as a San Jose, California narcotics detective. Later he was assigned to a DEA-run task force. As a government intelligence agent, Russell worked in Latin America observing narcotics trafficking during the Nicaragua-Contra conflict. In academia, he conducted studies of the impact of drug abuse on the crime index, wrote training programs for identifying the psychological and physiological symptoms of narcotics use, and developed rehabilitation programs designed specifically for the court-mandated client. He has traveled throughout the former Soviet Union and China to study their drug problems and policies. In the field of drug rehabilitation, Russell implemented and taught courses for various California and Texas counties, as well as for privately run programs. Russell is a court-recognized expert (on both the federal and state levels) in the field of narcotics enforcement. His journey to the Soviet Union made it clear to Russell that the “War on Drugs” cannot be won. “Drugs were prevalent even behind the Iron Curtain,” he reports. “If a country, as controlling of its citizens as the Soviet Union was, still had such a large a problem – drug-dealing on Moscow street corners, meth labs in Leningrad – how could a free society such as ours handle the problem from a law-enforcement perspective?” Russell rightly attests that from the advent of drug prohibition in 1914 to the declaration of “War on Drugs” in 1970, to our present-day policies and tactics, the US government has not significantly reduced the use and abuse of drugs. Instead we have incarcerated millions, destroyed the lives of countless youths, while corrupting police, judges, and politicians. “We are taxing our population at over 69 billion dollars a year to support this ‘War on Drugs,'” he notes, “and the result is the enrichment of drug lords, foreign government officials, and our own government agencies that are involved in this folly.” Russell champions a three-pronged approach to reform: 1) treat addiction as a health problem – not a crime, 2) remove the profit motive from the drug trade, and 3) redirect a portion of the billions of dollars in enforcement costs that ending prohibition would save toward real, honest education about drugs. Education programs cut the use of nicotine, the most addictive drug known to humans, in half in a 20-year period and we didn’t have to arrest or imprison anyone to achieve that success.
Check out this video of one of Russell’s public speeches:
And check out Russell’s book:
there is a group of ex-law enforcement and attorneys/judges Law Enforcement Against Prohibition
Here is a interesting 14 minute video that they explain why they are against the war on drugs
Filed under: General Problems | 3 Comments »
Maybe the CDC opiate dosing guidelines revision will get “tabled”
Posted on June 24, 2020 by Pharmaciststeve
Trump team weighs a CDC scrubbing to deflect mounting criticism
https://www.politico.com/news/2020/06/23/trump-cdc-overhaul-coronavirus-335039
With Trump under fire for his handling of the outbreak, his advisers are eyeing the federal bureaucracy for other culprits ahead of the election.
White House officials are putting a target on the Centers for Disease Control and Prevention, positioning the agency as a coronavirus scapegoat as cases surge in many states and the U.S. falls behind other nations that are taming the pandemic.
Trump administration aides in recent weeks have seriously discussed launching an in-depth evaluation of the agency to chart what they view as its missteps in responding to the pandemic including an early failure to deploy working test kits, according to four senior administration officials. Part of that audit would include examining more closely the state-by-state death toll to tally only the Americans who died from Covid-19 directly rather than other factors. About 120,000 people in the U.S. have died of the coronavirus so far, according to the CDC’s official count.
Aides have also discussed narrowing the mission of the agency or trying to embed more political appointees in it, according to interviews with 10 current and former senior administration officials and Republicans close to the White House. One official said the overall goal would be to make the CDC nimble and more responsive.
Politically, Trump aides have also been looking for a person or entity outside China to blame for the coronavirus response and have grown furious with the CDC, including its public health guidance and actions on testing, making it a prime target. But some wonder whether the wonky-sounding CDC, which the administration directly oversees, could be an effective fall guy on top of Trump’s efforts to blame the World Health Organization.
“WHO is an easy one,” said one former administration official. “It is foreign body in Switzerland. CDC will be tough to create a boogeyman around for the average voter.”
The moves are among the White House’s efforts to deflect attacks on President Donald Trump and place blame elsewhere in the federal bureaucracy. Protecting the president is seen as increasingly important by political aides as the general election approaches in just over four months and criticism mounts from former Vice President Joe Biden, other Democrats and even former national security adviser John Bolton, who say the blame rests squarely on Trump.
The efforts risk backfiring if they blame career health experts at the CDC, whose warnings early in the crisis were dismissed by Trump and his top aides as fearmongering.
Juliette Kayyem, an Obama-era former Homeland Security official who aided the response to the 2009 H1N1 pandemic, said it can be valuable for agencies to revisit their performance after a crisis — but that there’s no reason to single out the CDC.
“When the history books are written about this crisis, is anyone actually going to believe that America’s abysmal performance and its high death rate was because of some bureaucratic impediment at the CDC?” Kayyem said. “The core of America’s problem is a White House that clearly was not pressed into action in January. And every flaw — from CDC and testing to FEMA and the stockpiles to the supply chain and the states — every systemic problem is rooted in White House malfeasance.”
The discussion is ongoing about the best way to revamp an agency White House aides view as distant from the West Wing — and filled with government career officials who do not respect or follow the Trump agenda.
No single plan for tweaking the CDC has gained traction inside the administration, and the time frame for any evaluation or audit remains unclear. One administration official said aides have discussed having someone inside the administration do the evaluation, or possibly bringing in an outside public health expert to lead it.
During a visit to the CDC last week, Health and Human Services Secretary Alex Azar spoke with CDC Director Robert Redfield and other senior officials about how to move forward with the need for reforms of the agency, a senior administration official said. But the official said discussions are in their early stages, and they strongly disputed the suggestion that any evaluation of the CDC would amount to a scapegoating exercise.
An HHS spokesperson said the department does not comment on internal deliberations, and the CDC referred questions to the White House.
After this story first published, a senior White House official said the CDC was not being maligned. “We found a few inconsistencies in CDC data based on data that we’re getting from hospitals,” the official said. “This is not about minimizing the role of CDC but ensuring that the American public gets accurate and verified data.”
The CDC, with a staff of 20,000 people, has long served as a model for public health agencies around the world, with a global stature held by few U.S. agencies.
But even before the pandemic, Trump administration health officials had discussed shrinking the CDC’s purview — stressing to Redfield after his 2018 arrival that he should consider reorganizing and refocusing the public health agency.
The CDC had taken on a growing range of research projects and areas of study over the past several years, they argued, a steady expansion that risked distracting from its primary mission as the nation’s leading authority on identifying and responding to infectious disease threats. The CDC later published a strategic framework that defined the agency’s “five core capabilities.”
In Trump’s proposed budget for fiscal year 2021, the administration proposed a roughly 19 percent cut to the agency’s discretionary budget. This year’s budget plan also proposed to refocus the CDC on “its core mission of preventing and controlling infectious diseases and other emerging health issues, such as opioids.”
The coronavirus crisis — and the CDC’s high-profile missteps — have only strengthened the case for an overhaul, said a former senior official who was involved in those discussions.
“The thing to do is take a hard look at the CDC and say what are the five things that they really need to do, and do it to the exclusion of everything else,” the former official said, adding that Redfield had agreed with the prepandemic concerns that the agency’s activities were too scattered. “People have been talking about back to basics, core mission.”
Redfield’s job is not in danger with an election so close, but officials from across the White House orbit have zeroed in on the CDC as a major problem within the coronavirus response. The vice president’s office has expressed concern about the accuracy of the coronavirus death toll, while parts of the Office of Management and Budget, such as the United States Digital Service, have been involved in reviewing the data at the state level.
As the nation’s top public health authority, the CDC has traditionally played a central role in crafting the federal government’s response to health crises and communicating with the public. But the agency has assumed a far lower profile amid the pandemic, after a series of slip-ups that drew the ire of White House officials and hampered the administration’s early response effort.
Initial coronavirus tests developed by the CDC in February proved faulty, delaying widespread plans to screen for the virus and allowing it to spread throughout the nation for weeks. An internal HHS investigation released last week found that the faulty test kits were likely contaminated at the CDC.
Messages from CDC officials early in the crisis, while in line with assessments from the scientific community, have embarrassed White House officials trying to contain the political fallout.
Nancy Messonnier, a top CDC official, surprised the White House in late February when she told reporters that a coronavirus outbreak was inevitable — contradicting top officials’ assertions at the time that the disease was largely contained.
In April, Redfield drew Trump’s attention after he warned that the country could face a brutal second wave of the disease come the fall — a statement he was forced to clarify the next day.
And more recently, the agency has come under scrutiny from the White House over guidelines for reopening schools and institutions that were initially seen as overly prescriptive, and from public health experts for conflating two different types of coronavirus tests in its overall testing numbers.
One administration official said the main problem with the CDC has been with the data it receives from states about the Covid-19 death toll — creating a larger problem clouding the U.S. response.
“In Pennsylvania, if you have coronavirus and you die from a gunshot wound, it gets classified as a coronavirus death,” the administration official said. “If the data drives the decision-making, you want to make sure you have good data. When you have different ways of counting things, it can lead to distortion. The audit was suggested as means to confirm that or disprove that.”
Filed under: General Problems | 2 Comments »
Oxygen levels under face mask
Posted on June 24, 2020 by Pharmaciststeve
During the 80’s and 90’s our independent pharmacy was the largest respiratory supplier in two counties. We had a couple of hundred pts on home oxygen.. when a pt was on supplemental oxygen typically it was via nasal cannula at 2 LPM.. In those rare incidents where pts needed to put on a oxygen mask… it was necessary to bump up the oxygen flow to 5-6 LPM… so that the mask was flushed out between pt’s breaths of the CO2 the patient exhaled. If this was not done, CO2 is heavier than air and if not this higher flow and re-breathing CO2 could settle in the bottom of the lungs and block the Alveoli which exchanges the Oxygen in the air we breathe and getting it into the pt’s artery system.
I suspect that if the oxygen level could have been measured at the bottom of this pt’s lungs… it would probably been LOWER …
Filed under: General Problems | Leave a Comment »
The RAPP Report – my interview 06/24/2020
Posted on June 24, 2020 by Pharmaciststeve
https://therappreportpodcast.podbean.com/e/e10-interview-with-pharmacist-steve/
The chronic pain community has a new venue where a number of chronic pain advocates and chronic pain pts themselves are having a place to talk about how chronic pain is impacting pts and how changes are coming down the pike – both good and bad.
Last night I had the privilege to be in the Rapp Report’s “hot seat” and ended up talking about 90 minutes about issues all over the spectrum of issues that are impacting the chronic pain community and other pts that are dealing with subjective diseases.
I am sure that they would welcome input from the community on a topic/subjective material that some/many would like to have someone on the show to discuss. Here is their email therappreport.podcast@gmail.com
and here is their facebook page https://www.facebook.com/groups/247276683163131/
Filed under: General Problems | Leave a Comment »