You, sir or madam, are no pharmacist.
No pharmacist, or anyone with any sort of education, would blatantly say one drug is a better treatment for a disease/set of symptoms than another due to simple patient variability. That is besides the simple fact that methylphenidate (Ritalin) is already available as a generic.
And as far as ulcer treatments go you cannot assume that ALL ulcers are created equally - by H. pylori bacteria. The most common form of treatment for ulcers where H. pylori is implicated is a proton pump inhibitor (there is a generic in this class) and an antibiotic (clarithromycin, tetracycline or even amoxicillin, plenty of generic choices). How would antibiotic therapy be effective for a patient that does not have H. pylori?
Ever look in a pharmacy trade magazine? Plenty of generic medications are marketed.
Again, you are no pharmacist.
Actually, the clavulanate attempts to block the action of beta lactamase which is produced by certain strains of bacteria in response to the action of penicillins. Had your bacterial strain contained the plasmid needed produce the beta lactamase you would have been happy to get the Augmentin (but not the XR, it is a waste of money unless you really don't like taking multiple doses of medication per day).
Really, the pharmaceutical companies are KILLING people? What you are trying to say is by developing and marketing drugs meant to alleviate / cure diseases the companies are actually KILLING people?
People are getting the medicine they need whether by paying full price out of pocket, paying copays, having Medicaid pay for it or taking part in programs for free or low cost medications directly from the manufacturers. Are they always getting the latest, greatest, bestest, most perfectest medications? Probably not.
Wow, so where you live you can only have it one way or the other?
I would prefer to live in a nation where taxes are used for services and infrastructure for everyone's benefit while avoiding subsidizing people's stupid life decisions via the welfare system.
BTW, I donate more money to charity (my choice) then you and your sniveling liberal limp wristers could hope to scrape together.
Who says the "rich" benefit disproportionately? The "poor" have access to and make use of the same tax payer provided services, conveniences and protection as the "rich". Ever hear of Earned Income Credit? Poor people with kids get thousands of dollars from the federal government just for being poor.
When you calculate who benefits from government and its expenditures, don't forget that the maintenance of stable and predictable political, legal, and police systems is what makes it possible for "the poor" to use the government as their agent to steal my hard earned money in the first place.
Avandia and januvia will let the beta cells "rest" also.
The only two classes of drugs I can think of off the top of my head that actually stimulate beta cells are the sulfonylureas and meglitinides. I dispense a fair amount of sulfonylureas but we don't even keep either of the meglitinides in stock.
Avandia doesn't increase the workload on beta cells. If anything it REDUCES the beta cell workload as your cells are more responsive to the effects of insulin. In fact, metformin should also reduce beta cell workload as it decreases the amount of glucose produced in the liver.
The exact mechanism of beta cell decline in patients with T2DM, at least as far as I know, has not been definitively answered although chronic hyperstimulation is one proposed mechanism. If you have new research which answers that, please let me know.
If beta cells die off after insulin production we would all be type 1 diabetics.
Additionally, from what I understand about these incretin enhancers it seems that beta cell functionality IMPROVES and beta cell mass can INCREASE. They are also weight neutral and shouldn't have hypoglycemic side effects. So there is no reason for this medication causing a need for insulin injections.
With Avandia and Actos your cells are actually producing MORE insulin receptors so they draw more insulin in. Great for lowering blood sugar, bad for weight control.
For any person who has diabetes or is borderline, talk to your doctor, an endocrinologist or a pharmacist about treatments and monitoring.
Exubera is not dosed in units but in mg. Initial dosing is based on patient weight and can be adjusted as needed. For example, if a patient weighs between 133 and 175 lbs then he would receive 3 mg of inhaled insulin before a meal. The SubQ "equivalents" are more of a comparison, not a direct 1:1 conversion.
Actually Exubera would be good for people who take small amounts on insulin. A 1 mg blister is equivalent to 3 units of insulin while a 3mg blister is equivalent to 8 units of rapid acting insulin.
The only real advantage I can see for the device is for people who have an aversion to needles or are sick of injections.
Actually I see more Medicaid patients walking out of the pharmacy with $200-$600 worth of monthly prescriptions after paying their $5 copay than any other group of people. The state Medicaid programs usually have deals negotiated with the manufacturers so only the latest and most expensive brand name drugs are on the Medicaid formulary. The only people that have had a full monthly 30 tablet supply of Valtrex filled are pregnant Medicaid patients. Most of the other insured or uninsured patients will gladly switch from the once a day Valtrex ($10/tablet) to the four times a day generic acyclovir ($25 for the entire prescription).
Cinnamon, chrome and other OTC supplements really aren't going to help people with full blown diabetes. I have had patients (non controlled Type II DM) asking why there glucose levels are still 300+ after trying the chromium supplements they saw advertised on television.
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We sell Prilosec (omeprazole) by the boxload OTC for under fifty cents a day.
You, sir or madam, are no pharmacist. No pharmacist, or anyone with any sort of education, would blatantly say one drug is a better treatment for a disease/set of symptoms than another due to simple patient variability. That is besides the simple fact that methylphenidate (Ritalin) is already available as a generic. And as far as ulcer treatments go you cannot assume that ALL ulcers are created equally - by H. pylori bacteria. The most common form of treatment for ulcers where H. pylori is implicated is a proton pump inhibitor (there is a generic in this class) and an antibiotic (clarithromycin, tetracycline or even amoxicillin, plenty of generic choices). How would antibiotic therapy be effective for a patient that does not have H. pylori? Ever look in a pharmacy trade magazine? Plenty of generic medications are marketed. Again, you are no pharmacist.
Actually, the clavulanate attempts to block the action of beta lactamase which is produced by certain strains of bacteria in response to the action of penicillins. Had your bacterial strain contained the plasmid needed produce the beta lactamase you would have been happy to get the Augmentin (but not the XR, it is a waste of money unless you really don't like taking multiple doses of medication per day).
Really, the pharmaceutical companies are KILLING people? What you are trying to say is by developing and marketing drugs meant to alleviate / cure diseases the companies are actually KILLING people? People are getting the medicine they need whether by paying full price out of pocket, paying copays, having Medicaid pay for it or taking part in programs for free or low cost medications directly from the manufacturers. Are they always getting the latest, greatest, bestest, most perfectest medications? Probably not.
Wow, so where you live you can only have it one way or the other? I would prefer to live in a nation where taxes are used for services and infrastructure for everyone's benefit while avoiding subsidizing people's stupid life decisions via the welfare system. BTW, I donate more money to charity (my choice) then you and your sniveling liberal limp wristers could hope to scrape together.
Who says the "rich" benefit disproportionately? The "poor" have access to and make use of the same tax payer provided services, conveniences and protection as the "rich". Ever hear of Earned Income Credit? Poor people with kids get thousands of dollars from the federal government just for being poor.
When you calculate who benefits from government and its expenditures, don't forget that the maintenance of stable and predictable political, legal, and police systems is what makes it possible for "the poor" to use the government as their agent to steal my hard earned money in the first place.
Bravo! Excellent post! You certainly captured the spirit of the envirowackos.
Avandia and januvia will let the beta cells "rest" also. The only two classes of drugs I can think of off the top of my head that actually stimulate beta cells are the sulfonylureas and meglitinides. I dispense a fair amount of sulfonylureas but we don't even keep either of the meglitinides in stock.
Good for you, but next time could you address the previous post?
Avandia doesn't increase the workload on beta cells. If anything it REDUCES the beta cell workload as your cells are more responsive to the effects of insulin. In fact, metformin should also reduce beta cell workload as it decreases the amount of glucose produced in the liver. The exact mechanism of beta cell decline in patients with T2DM, at least as far as I know, has not been definitively answered although chronic hyperstimulation is one proposed mechanism. If you have new research which answers that, please let me know.
1000mg of chromium picolinate Are you sure you didn't mean 1000 mcg?
If beta cells die off after insulin production we would all be type 1 diabetics. Additionally, from what I understand about these incretin enhancers it seems that beta cell functionality IMPROVES and beta cell mass can INCREASE. They are also weight neutral and shouldn't have hypoglycemic side effects. So there is no reason for this medication causing a need for insulin injections. With Avandia and Actos your cells are actually producing MORE insulin receptors so they draw more insulin in. Great for lowering blood sugar, bad for weight control. For any person who has diabetes or is borderline, talk to your doctor, an endocrinologist or a pharmacist about treatments and monitoring.
Exubera is not dosed in units but in mg. Initial dosing is based on patient weight and can be adjusted as needed. For example, if a patient weighs between 133 and 175 lbs then he would receive 3 mg of inhaled insulin before a meal. The SubQ "equivalents" are more of a comparison, not a direct 1:1 conversion.
Actually Exubera would be good for people who take small amounts on insulin. A 1 mg blister is equivalent to 3 units of insulin while a 3mg blister is equivalent to 8 units of rapid acting insulin. The only real advantage I can see for the device is for people who have an aversion to needles or are sick of injections.
Actually I see more Medicaid patients walking out of the pharmacy with $200-$600 worth of monthly prescriptions after paying their $5 copay than any other group of people. The state Medicaid programs usually have deals negotiated with the manufacturers so only the latest and most expensive brand name drugs are on the Medicaid formulary. The only people that have had a full monthly 30 tablet supply of Valtrex filled are pregnant Medicaid patients. Most of the other insured or uninsured patients will gladly switch from the once a day Valtrex ($10/tablet) to the four times a day generic acyclovir ($25 for the entire prescription).
Cinnamon, chrome and other OTC supplements really aren't going to help people with full blown diabetes. I have had patients (non controlled Type II DM) asking why there glucose levels are still 300+ after trying the chromium supplements they saw advertised on television.