You might as well ask the dog

October 15, 2013

Friends, co-workers, and Auntie Alice are definitely not the folks to give you the best advice about drugs. And sometimes, neither is APhA.

 

 

 

 

 

 

 

We saw Rosalie, the only female member of the grounds crew where I live, at the end of our walk. My dog is still a puppy, so I stood there as Rosalie did what most women do with a puppy. She squealed, “Oh, you widdle baby boy, Buddy.” She rubbed Buddy’s head until he rolled onto his back. She scratched his belly. “You are a precious puppy wuppy.” Then she rotated her right arm and held it with her left hand, and grimaced.

“Pain?” I asked. Rosalie is thirty-something and fit. She does what some people think is a man’s job, and she does it well. I knew she could take care of herself. However, I had heard Katja, a member of the building maintenance crew, tell Rosalie that a certain pain medicine goes right to the pain and stays away from the rest of your body.

The drug is naproxen. According to Katja, it has no side effects. I reminded Rosalie that I am a pharmacist. After dispelling Katya’s counseling fantasy, I advised Rosalie to talk to a pharmacist about drugs. I added that she should always disregard anything she hears about drugs from Katja. 

Out of the frying pan

Americans get themselves into big trouble with drugs - legal drugs. Years ago, OTC analgesic ear drugs were removed from the market. They were too good. Without pain, an ear infection became mastoiditis, and that led to surgery. 

Everywhere you looked, there was the message: Drugs were good for you, they could solve any problem, they were safe. This has been a moneymaking proposition for close to 50 years. Plop, plop, fizz, fizz, Oh what a relief it is.

Americans do not respect the fact that drugs have dangerous properties. Why should we? They tell us how good the drug is, but the dangers are recited so quickly that we never really hear the four words sudden death is possible

For example

Axiron is a deodorant-style, testosterone-based muscle-builder for “Low T.” Of course, every parent knows that a Title IX girly-girl volleyball ace better not use it. Or do they? What’s not to like about increased muscle mass for a daughter heading for a major college scholarship? You can get anything on the black market, and Americans just do not respect drugs.

Saturday Night Live recently did a spoof featuring Serena Williams. It was called “Excedrin for Racial Tension Headaches.” There are people out there who think that a syndrome called Racial Tension Headache actually exists. Believe it. Of course it’s real. I saw it on TV.

Whose job is it to educate our culture in the idea that every single drug is a poison? Death is a function of dosage and frequency. The look on their faces when I say, You take enough often enough, and you are dead. Priceless.

50 years and waiting

Drug Topics once reported on the idea of a fourth drug class: Rx drugs that could be refilled at the discretion of the pharmacist. That was in April 1964, back in the olden days.

And APhA Executive Director William S. Apple, an unapologetic promoter of pharmacists and pharmacy, went to the wall for a third class of Behind the Counter drugs. In 1964.

What happened over there at APhA? (Of course, the AMA considered this idea to be a threat to the doctor’s turf.)

What did we get? Greed and arrogance, with no concern for the health and welfare of the consumer. Some OTC products are hazardous, but a lot more money is made when anyone can buy them. BTC would threaten profits.

Don’t ask Sally

The poster children for this proposition are Aunt Sally’s favorites: the drugs for yeast infection. Aunt Sally has diagnosed more incidents of vaginal candidiasis than any doctor or pharmacist you can name. 

 “It’s yeast, dear.” Aunt Sally always knows. “They have drugs now.”

The problem, Sally, is that bacterial vaginosis is much more prevalent than yeast. A pharmacist will ask the right questions. Is there a foul odor? What does the discharge look like? No odor and cottage-cheesy discharge, and Aunt Sally is good. A fishy odor and a grayish-white or yellow discharge, and you have bacteria.

If she listens to you, Sally, your favorite niece may end up with pelvic inflammatory disease. She may end up infertile. You want grandnieces and nephews, Sally? Refer Brenda to her pharmacist.

William S. Apple was out front on this, but he was left twisting in the wind.

BTC = Superior patient care. OTC = More profits. The difference? Greed and arrogance. Greed and arrogance. GREED AND ARROGANCE.