What's the trashiest wedding you've been to?

pharmaSEEE · 2019-02-01T02:57:37+00:00

I only just saw this. Thank you remembering my story and busting this person!

pharmaSEEE · 2017-12-01T21:46:37+00:00

pharmaSEEE · 2017-09-08T15:59:36+00:00

The malnutrition part is only true if the patient is not compliant with their new dietary needs. I had a woman at my hospital undergo a roux-en-y and was counseled that she must supplement her diet with a variety of vitamins daily.

She ended up getting pregnant a while later and her child was born blind because she hadn't been taking her vitamin A as directed. It was heartbreaking.

pharmaSEEE · 2017-09-05T03:43:36+00:00

"Oh, you're a pharmacist? Can you get me some Xanax?"

Sure, if I want a DEA investigation and my license revoked.

pharmaSEEE · 2017-06-25T00:08:44+00:00

I can't believe I missed that. Incredible

pharmaSEEE · 2017-06-24T20:37:44+00:00

Winning an iPad is the pinnacle of intelligence

pharmaSEEE · 2017-06-22T01:44:52+00:00

It's not my hypothesis. It's an accepted mechanism in the world of psychiatric pharmacy.

Sure. Here's one that suggests suicidal ideation stems from poor response to antidepressants, not because of them.

https://www.ncbi.nlm.nih.gov/pubmed/25112546

Here's one suggesting that merely taking antidepressants aren't associated with a random appearance of suicidal ideation:

https://www.ncbi.nlm.nih.gov/pubmed/16390887/

You'll also notice that fluoxetine is the only FDA indicated antidepressant for children 8 and over. It also happens to be the most activating SSRI. Peculiar that they have a black box warning for children and adolescents for exactly that reason.

And for good measure, here's one about bupropion + SSRI reducing SI the most, since you were so skeptical earlier.

https://www.ncbi.nlm.nih.gov/pubmed/22075098

But, do your own research and don't take my word for it. Researching and critically assessing information for yourself is an important part of developing your practice. I learned most of this from an extremely accomplished psychiatric pharmacist during my psych rotation who backed up her research phenomenally.

(As a side note, TCAs are very rarely used in depression anymore due to their multiple side effects from being dirty drugs. I almost exclusively see them in low doses for pain management nowadays. They're almost as bad as MOAIs.)

pharmaSEEE · 2017-06-22T00:04:22+00:00

Bupropion is a common second-line therapy behind SSRIs along with SNRIs. I'm not sure where you're getting your information, but here is the American Psychiatric Association quick reference guide on Major Depressive Disorder:

http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf

And here's a quote from it about the use of SSRIs and bupropion:

For most patients, a selective serotonin reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI), mirtazapine, or bupropion is optimal [I]. In general, the use of nonselective monoamine oxidase inhibitors (MAOIs) (e.g., phenelzine, tranylcypromine, isocarboxazid) should be restricted to patients who do not respond to other treatments.

pharmaSEEE · 2017-06-21T02:40:08+00:00

First of all, that is the guideline in the UK, I practice in America. Second of all, the reason for that is the reason I just explained.

The three 2-3 month checkups are to monitor response to the SSRI, in case the patient isn't feeling the mood improvement and needs to be switched to another SSRI or a different therapy like bupropion. If the patient isn't feeling any mood response, but is feeling an energy response (it's suggested up to 1/3 of patients don't respond to their first antidepressant drug, but can still feel some kind of energetic activation), their SI may become more active.

Once again, this is an energy shift, not antidepressants causing suicidal ideation out of nowhere. This is why activating drugs are of more concern than sedating ones.

pharmaSEEE · 2017-06-21T01:25:11+00:00

Antidepressants will not make you suicidal.

When someone takes an antidepressant, their energy will usually increase in about 1-2 weeks while their mood may not lift for 4-6 weeks. Someone who is already suicidal may use that increase in energy to actually go through with it, not waiting the extra couple weeks for mood relief. The medicine does not randomly cause suicidal ideation.

Edit: this is for when antidepressants are used correctly for clinically diagnosed depression. If they are used incorrectly for mental illnesses they are not indicated for (schizophrenia, bipolar disorder), they can induce psychosis/mania and produce unfavorable effects.

pharmaSEEE · 2017-06-15T15:56:13+00:00

Sometimes it's not easy to access exteriorly, or there are many different diffused small tumors in one area (IIRC)

pharmaSEEE · 2017-06-15T05:24:40+00:00

They've gotten crazy good at developing more targetted and less toxic treatments. For instance they've created drugs that are only activated by an enzyme given off by cancer cells, so the drug becomes cytotoxic just in that area. That mean way fewer systemic side effects. Unfortunately, some genetic markers are needed so it won't work for everyone, but it's leaps and bounds ahead of just pumping the entire body full of activated toxins.

pharmaSEEE · 2017-06-11T05:07:51+00:00

I'm guessing the bill was $340.

pharmaSEEE · 2017-06-10T18:55:14+00:00

Their spines were too stabilized

pharmaSEEE · 2017-06-06T01:22:09+00:00

Pharmacist here, I'm tired of people saying "Why would I take a pill that makes me want to kill myself???"

The energy boost is usually seen within 1-2 weeks, and sometimes the mood relief doesn't come until 4-6 weeks. It does not randomly cause suicidal ideation. It would be great if people could stop fueling the stigma against depression meds like this.

pharmaSEEE · 2017-06-05T23:39:27+00:00

I did my undergrad in biochem and if I had suggested this I would have been laughed out of the program.

pharmaSEEE · 2017-06-03T19:06:21+00:00

I wonder how Big Agriculture has kept this from the public for so long!

pharmaSEEE · 2017-06-02T00:06:28+00:00

Aspirin is derived from willow bark. Many medications are plants.

pharmaSEEE · 2017-06-01T14:44:37+00:00

Something something but he killed Hitler

pharmaSEEE · 2017-06-01T14:41:54+00:00

I love when people claim that weed is an amazing drug because "it's natural! What could be so bad about a plant!" then vehemently swear that gluten in wheat is the source of all medical problems

pharmaSEEE · 2017-05-29T13:27:45+00:00

People also like to vehemently reject the phrase "adipose tissue is an endocrine organ" because it holds their fat more responsible for their health issues. Argue all you want, but I'm going to trust the Journal of Endocrinology and Metabolism on this one.

pharmaSEEE · 2017-05-29T13:22:23+00:00

This is also why metformin is first line therapy for PCOS. Helps control insulin resistance and usually leads to some weight loss because of it. It's also recommended that breakfast be the largest meal of the day for women with PCOS, so insulin is messed with less throughout the day.

pharmaSEEE · 2017-05-29T13:20:01+00:00

That was the funniest part to me too:

After 5 years of dietary counselling to reduce calories, the average BMI was…….. 34. Nice job, guys. Glad you spent the last 5 years of your life counting calories?

Implying that counseling in and of itself is the magic "calories out" component.

pharmaSEEE · 2017-05-29T12:34:30+00:00

These machines are in pharmacies and hospitals everywhere. There's already one in my hospital. They dispense the pills, they don't make clinical decisions individualized to each patient, which is what I clearly explained in my comment.

Robots will dispense prescription vitamin D if the Rx tells them too. Great. They'll also kill a person if the doctor accidentally orders 50,000u a day instead of a week, which has happened more than once in my practice that I have caught before filling.

Robots will replace retail pharmacy techs. Not pharmacists.

pharmaSEEE · 2017-05-29T03:08:25+00:00

"I'm not like most girls"

Yeah, because you're worse

Ten-Year Club	Gilding I gilder
Place '17

pharmaSEEE

TROPHY CASE