Letters

October 10, 2005

Many, many thanks for your outstanding first part of a two-part series on "Drugs and Race" (Aug. 22), which looked at the growth of medications targeted to racial groups. Pharmacists need to get "up to speed" on this issue, especially the issue of genomics and how genomics influences prescription drug use.

It has been documented that some cardiovascular drugs have been linked to heart attacks and bear no obvious relationship to cholesterol levels, blood pressure, or any of the other usual suspects in heart disease. This strongly suggests that mechanisms such as inflammation can be caused by an infection or by a haywire immune system.

John P. Kane, professor of cardiology, University of California Medical Center, says that doctors and pharmacists might be able to screen patients' DNA and predict not only whether they are likely to have a heart attack, but which type of heart disease to expect and which drug or prescription or procedure might work. Instead of prescribing a cholesterol-lowering drug, such as rosuvastatin (Crestor), as indicated in the article, physicians and pharmacists might choose an anti-inflammatory drug depending on the gene makeup of the patient. This entire new field of genomics, DNA, and stem cells must be brought to the attention of the pharmacy profession. We pharmacists need to be brought up to speed ASAP.

To this end, PPSI's Pharmacy Council on Genomics, DNA, and Cells will be sponsoring a major education program entitled "Genome/Stem Cells: Basic 101" for practicing pharmacists on Saturday, March 18, 2006, from 1 PM to 4 PM at the San Francisco Hilton Hotel during APhA's annual meeting. Speakers include Kathleen Giacomini, R.Ph., Ph.D., professor, biopharmaceutical science, cellular and molecular pharmacy, UCSF, and foremost leader in genomics in the field, along with Arnold Kriegstein, M.D., Ph.D., director, UCSF Developmental and Stem Cell Biology, professor, neurology, UCSF, and Gina Smith, author of The Genomic Age.

I look forward to Part Two and Drug Topics taking the lead in educating pharmacists on this most important issue of genomics.

Joseph I. Rotenberg, R.Ph., Chairman
Pharmacy Council on Genomics, DNA & Stem Cells
Pharmacists Planning Service Inc.
Tiburon, Calif.
tiburonjoe@comcast.net

Many factors influenced verdict

Regarding your September on-line Instant Poll on whether the Vioxx verdict was fair, there are too many unknowns. Was Merck so arrogant that the jury hated it? Did the evidence show that Merck tried to bury the adverse effects? What effect did the personalities of the attorneys play in the decision? Did they try to keep it simple or overwhelm the jury? There are too many variables, including the jurisdiction and the presentation of the witnesses, to accurately make a statement regarding ANY verdict.

Kathleen Davoren, JD, R.Ph.cjd52@infionline.net

Emergency contraception and bioethics

I'm going to have to take the opposite view with regard to your July 25 Viewpoint, "Refusing to dispense carries legal risks." In a nutshell, here are my views.

I agree that contraception is not abortion, and your statement is true that "in the normal life of a sexually active female, there are many instances when a fertilized egg fails to attach to the uterine wall and is expelled as part of the menstrual cycle." This is natural and "man" or science did not manipulate anything in this situation.