Hepatitis C has been in the news a lot recently. On one hand, the advances in research have some touting the disease on the verge of being "cured." On the other hand, the "Because We Can, That's Why" $1000 per pill regimens are coming under scrutiny from congress.
Many of us try to avoid Hepatitis C (HCV) because so much of the therapeutics are new and "foreign" to us. Also, the HCV treatment guidelines have changed at least twice in the time it's taken you to read this far. But HCV isn't going away. And you know it's going to be on the NAPLEX. So let's dig in, and see if we can't make some sense of this ever-evolving disease.
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As a health care professional, one of your duties is to evaluate literature and make clinical decisions for your patients. What? I didn't say it was an easy part of your job. Maybe not even a fun part. You've got to be able to separate the wheat from the chaff. To read between the lines and see through the BS. To arrive at that happy place where sound evidence-based decisions come from.
This special tl;dr two-part post will help you see some of Big Pharma's tricks--so you'll be better prepared when you read up on that new drug approved by the FDA.
Part I is like a mini journal club. We'll focus on a recent secondary analysis of the ARISTOTLE trial.
Part II will take a broader look at the other marketing practices of Big Pharma.
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Here's the scene. I'm a new PGY1 resident. I'm still a little nervous with the whole "residency" thing. I'm on my first rotation, covering is an IMC unit (which has patients less sick than an ICU, but more sick than a regular medicine floor). It's still early in the residency, and I'm already tired. Rounds start at 9am, but I arrived hours before to work up my patients. And I woke up hours before that because I hadn't yet lost my motivation for exercise and general health and wellness.
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There's a dirty little secret about life in the first few months after graduation. Many, if not most, entered this profession with the promises of riches and fame (well, maybe not the fame). The initial offer from that major pharmacy chain has more significant figures than your algebra teacher ever required you to round to. And for nearly everyone it will be a tremendous jump in income. Especially considering you've been living on so many student loans that your net income has been negative for 4 years.
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The moment you press "submit" on PhORCAS, the doubting begins. It lives in the back of your mind. And it's scary as hell.
You try to go on about your day. You try not to think too much about it. You go work out. You play some Call of Duty. You binge-watch Downton Abbey. But like a small itch, there it is. Nagging you. The question lingers somewhere in your brain no matter what you do.
What if you don't match for residency?
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If you are a future (or current) pharmacist, you need to know warfarin. You don't need me to tell you that. Every teacher and preceptor you've had since you started school has been drilling that into your head.
However you've probably also noticed that few will actually tell you how to dose warfarin. Sure, you learn about purple toes and birth defects, but that doesn't tell you what to do when your patient's INR is 5.6.
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Imagine it's your first week of an APPE rotation at an anticoagulation clinic. You're excited and a little nervous. You've been brushing up on your Lovenox. You've read all you can about Eliquis and Xarelto and Pradaxa (oh my!). You're ready to impress.
Then there's the elephant in the room that is warfarin. Sure, you know lots about it. You can rattle off facts about VKORC1, and R and S enantiomers. You know that the pills are color coded by strength.
But how do you actually dose warfarin? If you're like most of us, you probably don't feel adequately prepared to jump right into managing wafarin therapy with what you learned in the classroom.
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Editors Note: This is a test post. We're doing this to gather feedback from you. Do you like this format for new FDA approval posts? Do you dislike it? Please let us know in the comments!
If feedback is positive, we will post something similar to this when new drugs are approved by the FDA.
Drug:
Lenvatinib [Lenvima]
Indication:
Locally recurrent or metastatic, progressive, radioactive iodine-refractory differentiated thyroid cancer
I’m sorry, what in the heck did you just say?
Lenvatinib can be used to treat the vast majority of thyroid cancers (differentiated thyroid cancers account for about 94% of all thyroid carcinomas according to NCCN)--after they have failed radiation therapy.
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Hey everyone! Brandon and Sam here. We're the founders of tl;dr pharmacy.
Let's just come out with it: Pharmacy School is hard. No matter what program or year you're in, pharmacy school is the dominant part of your life. And what a stressful life it is.
Sleepless nights. Tests. Quizzes. Quizzlets. Exams. Quizzams. Presentations. Group projects. Monographs. Clinical labs. Sitting through 8 hour lecture days (and being expected to pay attention). Navigating a sea of professional organizations and fraternities. Ignoring friends and family for weeks at a time because you're "too busy." A growing six figure pile of debt. Picking up hours as an intern so you can buy food. Fire and brimstone falling from the sky. Cats and dogs living together, mass hysteria.
It's something we've come to call "The Struggle." Every pharmacy student intuitively understands it, but no one can really explain it to someone outside of the profession.
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Monoclonal antibodies (-mabs) are a common source of confusion for pharmacy students. They have long, hard-to-pronounce names that all look and sound alike. It's impossible to tell them apart, let alone keep track of where they're used therapeutically.
Well that ends today, you smarty pants tl;dr pharmacy reader, you. Today we're going to show you how to make sense of the entangled maze of -mabs. We're going to show you that there is actually a system to how monoclonal antibodies are named.
Why bother? Because you can tell most of what you need to know about a monoclonal antibody just by the name. You can learn a few simple rules that apply everywhere instead of crowding your brain memorizing endless details that you'll eventually forget after the test.
You can perform better on tests while spending less time studying and still remember the information.
Not to mention, -mabs are the future. They aren't going anywhere. You are going to see more and more of them because they're effective (both clinically and at making money for Genzyme shareholders).
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If you are reading this, I am reasonably confident that you have been through the interview process before. Maybe it was for a job, maybe it was for pharmacy school or residency--but more than likely you’ve experienced the sweaty palmed, butterflied stomach anxiety that is “the interview.”
But what if interviewing didn’t have to be like this? What if you could learn to not only tolerate but to thrive in an interview? What if you could walk into an interview knowing that you are the best person for the job?
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