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Pharmacist and Haiti medical missionary Ed Monroe

I have known Ed Monroe for a couple of years.  We became aware of each other because we are both pharmacists and we both have a heart for Haiti’s incredible people.   I first found out about Ed at  Friends of the Children of Haiti

Ed has been retired for a couple of years, but his primary focus has been on Haiti for a long time.

Ed lives near Chicago in Peoria, Illinois. He puts together several medical missions to Haiti every year. Ed can always use more volunteer missionaries with all kinds of skills and backgrounds. He can always use more money also.

If you live near Chicago and are interested in helping Ed out you can contact him on his web site or you can email him at edmonroe316@msn.com

You can learn more about Ed and his missions to Haiti by following him by clicking on this link to his blog at  What’s Ed Up to Now

Here’s a copy of an entry in Ed’s blog:

“We survived the trip over the mountains from the clinic to the PAP airport although there was some scares along the way. As of today, Monday, I have heard from some of the team and all are at home or will soon be home safely.”

”On Thursday we finished seeing patients sometime around noon. Our team saw a record 2212 patients on this mission. I am so very proud of all of the team members. After lunch, some of the team headed for the beach while a few of us readied the clinic for inventory and clean up. When the team returned they worked hard and completed the inventory. I should tell you that we had extra items to count. You may recall that Lynn and I had an appointment at a nearby school on Tuesday to pick up supplies. That turned out to be 4 truckloads of merchandise. We retrieved one on Tuesday and one on Wednesday and Boyer finished the work for us so we could get back to seeing patients. Some of the boxes were infested with termites. I managed to get bitten by a spider as I carried some boxes. I have the list of supplies so that our medical supply people can go over them. I did discover a full case of pints of cough syrup with good dating and also some melatonin spray that made Dr Jo pleased. On Wednesday, I had a visit from my friend Nego Pierre Louis. He is a young youth minister in Haiti. He introduced me to Ellen, his Canadian bride to be. They were married on Friday so I could not attend the wedding. That would have been fun.

I did manage to drop my laptop on Thursday night as I was inputting the pharmacy inventory data and lost about 1 hour’s time. It is okay and I brought the hard copies home to key here at my desk.”

……………………………

Are you interested in Helping out with missions work?

If you live in the Charlotte, North Carolina area and also have a heart for the people and would like to get involved in missions to Haiti or in other South America countries you can contact the Providence Rd Church of Christ missions team at: http://prcoc-missions.com/contactus.aspx or at the PRCOC.org

Technorati Tags: Ed Monroe, Haiti Medical Missions

Can People Catch Swine Flu?

Swine flu viruses do not normally infect humans. However, sporadic human infections with swine flu have occurred. Most commonly, these cases occur in persons with direct exposure to pigs (e.g. children near pigs at a fair or workers in the swine industry). In addition, there have been documented cases of one person spreading swine flu to others. For example, an outbreak of apparent swine flu infection in pigs in Wisconsin in 1988 resulted in multiple human infections, and, although no community outbreak resulted, there was antibody evidence of virus transmission from the patient to health care workers who had close contact with the patient.

How common is swine flu infection in humans?
In the past, CDC received reports of approximately one human swine influenza virus infection every one to two years in the U.S., but from December 2005 through February 2009, 12 cases of human infection with swine influenza have been reported.

What are the symptoms of swine flu in humans?
The symptoms of swine flu in people are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Check out this link for more information about swine flu >  

http://www.cdc.gov/swineflu/key_facts.htm

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by Bob Diamond R.Ph

CA-MRSA Staph Infection

Methycillin-resistant staphylococcus aureus (MRSA) is a well-known public health problem.

I just read a new study in the September 2008 issue of the North Carolina Medical Journal The study was about Community Acquired - Methycillin Resistant Staphylococcus Aureus, better known as a CA-MRSA infection, in children under 18 years old.

This is different than the MRSA (pronounced mersa) skin infection that has been acquired in a hospital setting. If a staph infection was acquired in the hospital, it is called HA-MRSA.

The Wake Forest University School of Medicine conducted the study.

This study was designed to look at children who reported to an emergency room with a skin abscess (skin infection with puss) that looked like it might be MRSA. If the child had not been admitted to a hospital within the last 30 days, and they had MRSA, it was determined to be community acquired. The study covered an 18-month period. 88 children were evaluated. They ranged in age from 2 weeks to 17 years.

After the CA-MRSA infection was identified by the doctor, each individual infection was tested by a laboratory to determine which antibiotics were the most effective against it.

The study concluded that community acquired-MRSA was responsible for almost 90 percent of the skin abscesses that were seen in the emergency department during that time.

The most interesting fact that came out of this study was that if an abscess was less than two inches (five centimeters) across, the wound would usually heal, if the doctor cleaned and debrided (removed dead or diseased tissue) the wound thoroughly, whether he administered antibiotics of not.

If the wound was larger than two inches, then the patient would only be healed if they were admitted to the hospital, and given aggressive antibiotic treatment.

One thing this study demonstrated is that CA-MRSA is not normally life threatening if it is taken care of while the size of the abscess is less than two inches. If you wait too long to treat it, then it can become life threatening.

If you see an infection on a child’s skin that has puss in it you need to treat it is as soon as possible, before it becomes a serious problem.

Click here for the North Carolina Medical Journal

Bob Diamond R.Ph

www.BobthePharmacist.com

DiamondRN@gmail.com

Technorati Tags: CA-MRSA, MRSA, staph infection

FDA Advisory Committees Vote to Ban Propoxyphene Products

Joint meeting of Anesthetic and Life Support Drugs and Drug Safety and Risk Management Advisory Committees determines risks outweigh benefits of Darvon and Darvocet.

FDA’s Anesthetic and Life Support Drugs Advisory Committee and Drug Safety and Risk Management Advisory Committee held a joint meeting January 30 to discuss the safety and efficacy of propoxyphene (Darvon) and propoxyphene-combination products. Committee members voted 14 to 12 to recommend that FDA discontinue marketing these products.

An introductory memo to meeting participants from Bob Rappaport, MD, Director of the Division of Anesthesia, Analgesia, and Rheumatology Products in FDA’s Center for Drug Evaluation and Research, included the following:

• There is insufficient evidence to establish that propoxyphene alone is an effective analgesic.
• The Committee on Safety of Medicines, under the Medicines and Healthcare Products Regulatory Agency of the UK, determined that the risk of deliberate and accidental overdose was unacceptably high and the product should be withdrawn from the UK market.
• Propoxyphene and its major metabolite are potent cardiotoxic agents with a narrow therapeutic index.
• Propoxyphene is widely prescribed, especially in the elderly, and has been associated with a large number of deaths.

The re-evaluation of propoxyphene came about in response to a Public Citizen petition file in February 2006, which stated, “Propoxyphene (now sold mainly as a generic drug), … has been associated with 2110 reported accidental deaths in the U.S. from 1981 through 1999.”

Representatives from FDA and the Substance Abuse and Mental Health Services Administration (SAMHSA) presented data on the efficacy and safety of propoxyphene documented in the New Drug Applications for the products and in the medical literature, as well as adverse event data from FDA’s Adverse Event reporting System and from SAMHSA’s Drug Abuse Warning Network (DAWN). Members also reviewed outpatient prescription usage data.

Xanodyne Pharmaceuticals, Inc., and Qualitest/Vintage Pharmaceuticals argued that the Public Citizen Petition “did not present credible scientific evidence that propoxyphene drugs are unsafe or ineffective when used according to approved labeling.” They maintained that the safety and efficacy of the product had been reaffirmed over the years with the approval of new formulations, new strengths, and new combination products. Their summary document stated, “[The] risks have not prevented the safe use of propoxyphene in accordance with the approved prescribing information,” and reminded committee members that safe use of the drug is safeguarded by its classification as a Schedule IV drug under the Controlled Substances Act.

FDA is not required to follow the joint committee recommendation.

Note*  I hope they are successful in removing propoxyphene in all forms from the market.  I have seen several patients highly addicted to it over the years.

Technorati Tags: darvocet, darvon, propoxyphene, propoxyphene HCL

Medarex Receives Milestone Payment for Investigational Antibody Targeting Integrin Receptors 2008-11-05, Source: Medarex, Inc. DRUGS cnto-95 COMPANIES: medarex inc centocor inc Medarex, Inc. today announced that it has received a milestone payment of an undisclosed amount from its licensing partner, Centocor R and D Inc., for the completion of a Phase 2 trial of CNTO 95, a fully human antibody targeting the integrin receptors that are implicated in tumor-induced angiogenesis. The CNTO 95 human antibody was generated using Medarex’s UltiMAb(R) technology. Medarex may receive future milestone payments and royalties should this product candidate progress to commercialization and achieve commercial sales.

Technorati Tags: cancer drugs, CNTO 95, oncology

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A Real Eye Opener

Diana Jason , PharmD Candidate 2009
Southern Illinois University Edwardsville 
Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

Have you ever gone to the doctor’s office and forgot half of the information you were given?

Healthcare professionals are trained to tell patients how to take their medications correctly. However, stress and anxiety levels can increase in the doctor’s office. This can make it difficult for patients to remember everything that was said. It is suggested for patients to take notes in the doctor’s office, so that they do not forget anything. Patients are also encouraged to ask questions if they do not understand.

Do as I say not As I do

As a student in my last year of pharmacy school, it is easy for me to tell patients about their medicines and what they SHOULD be doing. My whole world flipped upside down when I became the patient. I would like to share a story with you of something that happened to me recently. I learned the hard way, but I hope that patients can learn these lessons through my mistakes.

The Student Pharmacist becomes the Patient

I was at work when my right eye started hurting. I took out my contact lens. After lunch, it became red and swollen. I could not see as well, and I hurried to the nearest clinic. I was told by the nurse that I was to have an eye exam. I asked how I was supposed to have an eye exam when I can’t see! She said she would just go and get the doctor then. I anxiously waited for what seemed like forever. The doctor finally arrived. He examined my eye and told me I had a corneal abrasion from my contact lens.

He gave me a prescription for an eye ointment that contained an antibiotic for the infection as well as something for the pain. When I returned to work about 15 minutes later, I was asked what the doctor told me. I recalled that he said to wash my eyes 3-4 times per day with “ionized water” that I could pick up at the pharmacy. I also said I had a prescription for an eye ointment but could not recall how often or how to use it.   

Lessons Learned

• When I became a patient, my anxiety level went up because I was concerned about my eye  and  vision. I was in so much pain and so anxious that I could not remember what the doctor told me. I should have been more prepared and realized that this is absolutely normal.

• I should have asked questions when I did not understand the information I was given. I thought the doctor told me to use “ionized water” but he probably said “distilled water.” Ionized water is not even sold in a pharmacy.

• It doesn’t matter how smart you are or what you know. When you become sick, it’s hard to focus on anything besides the pain and wanting to feel better.

• A corneal abrasion results from cutting or scratching the thin, protective outer layer of the eye. In this case, it may have occurred from wearing the contact lens for too long.

• I had not been taught yet how to administer eye ointments. I should have asked either the doctor or pharmacist. These are the instructions:
  

  1. Wash your hands with soap and water before and after using this medicine.

  2. Remove the protective cap.

  3. Tilt your head back slightly and pull your lower eyelid down with your index finger to form a pouch.

  4. Using your other hand, place the tube as near as possible to your eyelid. Do NOT touch the tip of the ointment tube to the eye because bacteria from the skin could enter the ointment tube.

  5. Squeeze the end of the tube to apply a thin layer of the ointment to the pouch made by the lower lid and the eye. A ½ inch strip of ointment usually is enough.

  6. Close the eye gently for 1-2 minutes to allow the medication to be absorbed.

  7. Replace and tighten the cap right away.

  8. Wipe off any excess ointment from your eyelids and lashes with a clean tissue.

  9. This medicine may cause blurred vision when you first put it in your eye . Do NOT drive or do anything else that might be dangerous unless you can see clearly. 

Applying the Lessons Learned

When you are feeling sick, it can be hard to remember what the doctor said. Here are some tips if you ever find yourself in a situation like mine:

• Ask for written instructions. They will come in handy when you arrive home and cannot remember the instructions you were given.

• Ask for patient handouts about your condition or medications.

• Have all your prescriptions filled by one pharmacy. This is the only way your pharmacist can check to make sure all your prescription drugs do not interact with each other. You will also get to know your pharmacist better and feel comfortable asking more questions.

• Make sure that the pharmacist explains what the medicine you are receiving is used to treat, how to take it and what side effects it may cause.

• Bring along a family member or friend. If you miss something the doctor said, they can help you recall.

Remember that prescription medicines cannot work unless you take them correctly. Follow the above strategies and always feel free to ask your pharmacist if you have any questions. Do not be embarrassed if you forget what was said in the doctor’s office. Even student pharmacists occasionally do that.

© 2008 Consumer health Information Corporation. All rights reserved.

Technorati Tags: eye injury, use eye medicine

Source: the National Institute of Neurological Disorders and Stroke - NINDS

Parkinson’s disease (PD) belongs to a group of conditions called motor system disorders, which are the result of the loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, or trembling in hands, arms, legs, jaw, and face; rigidity, or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability, or impaired balance and coordination. As these symptoms become more pronounced, patients may have difficulty walking, talking, or completing other simple tasks. PD usually affects people over the age of 50.  Early symptoms of PD are subtle and occur gradually.  In some people the disease progresses more quickly than in others.  As the disease progresses, the shaking, or tremor, which affects the majority of PD patients may begin to interfere with daily activities.  Other symptoms may include depression and other emotional changes; difficulty in swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.  There are currently no blood or laboratory tests that have been proven to help in diagnosing sporadic PD.  Therefore the diagnosis is based on medical history and a neurological examination.  The disease can be difficult to diagnose accurately.   Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases.

Is there any treatment?

Technorati Tags: deep brain stimulation, parkinson's disease

FDA News

FDA Approves 2008-2009 Flu Vaccines

The U.S. Food and Drug Administration (FDA) today announced that it has approved this year’s seasonal influenza vaccines that include new strains of the virus likely to cause flu in the United States during the 2008-2009 season.

The six vaccines and their manufacturers are: CSL Limited, Afluria; GlaxoSmithKline Biologicals, Fluarix; ID Biomedical Corporation of Quebec, FluLaval; MedImmune Vaccines Inc., FluMist; Novartis Vaccines and Diagnostics Limited, Fluvirin; and Sanofi Pasteur Inc., Fluzone.

Approval information and specific indications can be found at http://www.fda.gov/cber/flu/flu2008.htm.

This season’s vaccines contain three strains of the influenza virus that disease experts expect to be the most likely cause of the flu in the United States.

Each season’s vaccines are modified to reflect the virus strains most likely to be circulating. The closer the match between the circulating strains and the strains in the vaccines, the better the protection.

There is always a possibility of a less than optimal match between the virus strains predicted to circulate and what virus strains end up causing the most illness. Even if the vaccines and the circulating strains are not an exact match, they will provide some protection and may reduce the severity of the illness or prevent flu-related complications.

“One of the biggest challenges in the fight against influenza is producing new vaccines every year,” said Jesse L. Goodman, M.D., M.P.H., director of FDA’s Center for Biologics Evaluation and Research. “There is no other instance where new vaccines must be made every year. The approval of flu vaccines is a part of FDA’s mission to promote the health of Americans throughout the year.”

The FDA changed all three strains for this year’s influenza vaccine—an unusual occurrence, as usually only one or two strains are updated from year to year. A list of the strains included in the 2008-2009 vaccine can be found at http://www.fda.gov/cber/flu/flu2008.htm. Of note, two of the three strains recommended for the U.S. this year are now in use for the Southern Hemisphere’s 2008 influenza season, which is currently underway.

Each year, experts from the FDA, World Health Organization, U.S. Centers for Disease Control and Prevention (CDC), and other institutions study virus samples and patterns collected throughout the year from around the world in an effort to identify strains that may cause the most illness in the upcoming season.

Based on those forecasts and on the recommendations of its Advisory Committee, the FDA each February decides on the three strains that manufacturers should include in their vaccines for the U.S. population. The FDA makes this decision early in the year so that manufacturers have enough time to produce the new vaccines.

Vaccination remains the cornerstone of preventing influenza, a contagious respiratory illness caused by influenza viruses. According to the CDC, every year an average of 5 to 20 percent of the U.S. population gets the flu, more than 200,000 are hospitalized from flu complications and there are about 36,000 flu-related deaths. Some individuals—the elderly, young children, and people with chronic medical conditions —are at higher risk for flu-related complications. Vaccination of these groups and of health care personnel is critical.

“Currently, only 40 percent of health care workers in the United States are vaccinated against influenza,” said Department of Health and Human Services’ Assistant Secretary of Health Joxel Garcia, M.D., M.B.A.

“Increasing the number of vaccinated health care personnel can be a strong front in the annual battle against the flu,” said Garcia. “Health care workers can set an example for the patients they serve as well as decrease the likelihood of contracting and transmitting the virus.”

Technorati Tags: flu vaccine, vaccine