Letters to the editor, November 5, 2007

November 5, 2007

Aspirin is one treatment that can be used with patients with deep vein thrombosis.

Pharmacists: Assert yourselves

In your Oct. 8 cover story-"Are you getting pharmacy's message across?"-you identified the passive behavior of the profession and the ineffectiveness of this approach. A further problem is that those of us who dare to openly criticize our poor treatment from government, insurance companies, academia, or Pharma are then both castigated and ostracized by the pharmacy-elected leadership-the same leadership that is unwilling to risk upsetting the entities that continue to unfairly treat the profession.

At the beginning of WWII, the Prime Minister of England was Neville Chamberlain. He was a passive man who believed that striking an accord with the Axis forces would allow England to remain unharmed. We know all too well that not only was England damaged irreparably but Europe also would never be the same. Winston Churchill succeeded him. It was through his harsh resolve that he guided England, formed a strategic success plan with other Allied nations, and was successful in stemming the tide of a destructive element.

My efforts to push pharmacy forward and past these barriers have met with disdain from within the leadership of the profession. It has been said that my direct approach to making things happen is strident. Maybe if pharmacy leadership had more resolve to push harder their agenda, the profession would not be in the quagmire it currently occupies.

Allen Nichol, Pharm.D.
Director
Diabetes Management Program
Grandview Family Practice
Columbus, Ohio
Allen.Nichol@odh.ohio.gov

Aspirin can help DVT

According to the Special Report in your Sept. 17 issue, an estimated two million people suffer annually from deep vein thrombosis (DVT), and 300,000 die from a pulmonary embolism (PE) as a result of DVT-more than breast cancer and AIDS combined. In the article, pharmacist Edith Nutescu noted that "only a small fraction of hospitalized medical patients receive thrombophylaxis."

The risk of PE and DVT can be prevented by at least a third if patients take a low-dose aspirin preoperatively and continued it for 35 days (Lancet 2000 Apr. 15;355;1295-1302). A WHO study showed that plane, train, bus, or auto passengers are at higher risk of DVT due to stagnation of blood and prolonged immobility, and the risk remains for four weeks.

Thirty million people in the United States have peripheral artery disease (PAD), and aspirin remains the first line of defense (Heart 2007;93:303-308). Low-dose aspirin now comes in a fast-dissolving tablet, Fasprin, which dissolves in the mouth and is absorbed by the buccal mucosa. For those with PAD, and those at risk for DVT and PE, a Fasprin a day may provide a simple solution.

Ed Petrus, M.D.
Austin, Texas
ejp.tx@sbcglobal.net

Love your digital edition!

I commend your magazine for going digital! I always enjoy reading the newest issue of Drug Topics when it arrives at my work and am always disappointed to have to put it into the recycling bin. In a country where far too many people are seemingly oblivious to the huge amount of waste generated daily, it is a welcome change to see your magazine take the smart step of going digital to reduce waste. The digital format is a very user-friendly design, and the zoom feature is awesome. Keep up the good work! I encourage your readers to make the switch today.

Chris Wade, Pharm.D.
Inpatient Hospital Pharmacist
Sutter Chanate Hospital
Santa Rosa, Calif.
cgwade@hotmail.com

For the record: In the Sept. 17 "Clinical Twisters," one of our respondents inadvertently misplaced a decimal point. We regret that our editing staff did not catch this before the column appeared in print. The correct adult dose for digoxin is 0.125 mg daily when renal function is normal.