Summary:  The big pharmaceutical companies have always had a choice:  whether to place their focus on the patient or on profits.  Every pharmaceutical company (Eli Lilly has determined that they are a “medicine company’) will attempt to present as being there for the people, and they will have a business plan that is about profits and the “health” of the company.  But Big Pharma is not in the clothing or automobile business…they are in the “health of the people” business.  So why develop a drug that – due to its price – may be out of reach for the average patient in need?  Profits for the drug company are expected, but to what extent, and at what cost?   Topics:·      Name it to Hate it 01:30·      Public Distrust in Big Pharma 03:00       ($$$, Concealing Facts about Safety, Patents)·      Research & Development/Rx Sales 04:15·      Humira – a monoclonal antibody 06:40·      New Drug Application & Patent 07:00·      More Patents and More Money 08:20·      Biosimilar Options Prevented 09:00·      Enbrel 09:45·      Meds for the People 10:30·      Bernie Sanders – HELP Committee 11:15·      Drug Advertising 12:15·      Vioxx 13:55·      Purdue Pharma – Oxycontin 14:40·      Free Lunches 16:50·      Big Pharma Lobbyists 18:00·      1800 Lobbyists for 535 Members of Congress 20:00·      Be a Lobbyist for You! 20:30·      In the Meantime – Pharmacoeconomics 21:20·      Monitor – Journal – Communicate 22:45·      Know what we Don’t Know 22:20·      Greed is Real 26:40·      Participate 27:40 Questions and comments to [email protected]

 Summary:  The goal is always to have zero medication errors, and yet they occur.  This episode takes a look at what is considered a medication error (missed doses count), how often medication errors occur, how often they cause harm to the patient (who is actually a person), and the importance of a team-approach (pharmacists, physicians, nurses, patients, and anyone who is part of the person's healthcare)  to preventing medication errors. Topics:·      Medication Errors – Commission & Omission 04:30·      Med Error Prevention:  Team Approach 04:45·      Flexeril Dose 06:45·      Beers Criteria Medication List 07:00·      Medication Errors -> Drug Related Problems 08:00·      ER Visits due to Medication Events (14%) 09:15       (32% of these due to noncompliance)·      Hospital Discharge Meds Knowledge      (28% of patients could list discharge meds;      Fewer could state intended use of medications.·      Journaling 13:15·      Frequency of Medication Use 14:10·      Polypharmacy 15:30·      Medication Error Incidence & Harm 16:50·      Medication Error Incidence of Death 19:00  Questions and comments to [email protected]

Summary:  The discussion of medication errors continues here, with a focus on the opportunities to prevent medication errors.  Not all prescription medications are created equal.  Regarding medication errors, this means that the potential adverse events that might occur, with an error, are more severe with high-risk medications.  Are you on a high-risk med?  Once again, a person who is familiar with their drugs, and motivated to participate in their own care, with their healthcare team, is essential to medication management, including preventing medication errors.  And finally, a reminder:  you are not on an island. Work with your healthcare team, including your pharmacist.    Topics:·      The 5 Rights of Medication Administration 01:30·      Pill Identifier 02:45·      Risk Factors 09:00·      Patient Education 10:30·      Indication? 11:15·      Intended Outcome? 11:30·      Adverse Events (possible) 11:40·      High Risk Medications 12:30·      Blood Thinners 13:30·      Minimize Distractions 14:45·      Drugs in Drug Errors 16:10      Insulins/Albuterol/Morphine/Potassium Chloride      Heparin/Levofloxacin/Cephalexin/Furosemide     Vancomycin·      Medication Adverse Events in ER Visits 19:00       And Hospitalizations·      Monitor Drugs with High Risk of Toxicity 21:00      (Warfarin, Insulins, Digoxin…)·      Medication Reconciliation 21:30·      Journal and Team Approach 23:10·      “Human Proof”? 23:30Questions and comments to [email protected]

Summary: To be more involved in your healthcare - your medications in particular - and to be able to participate in a conversation with your pharmacist or doctor, you might need to become your own detective.  And to that end, this episode briefly reviews the different drug classes in order to help you to realize the “whys” of your drug regimen, and in turn to more actively participate in your care, with your healthcare team.  Topics:·      Allergic Reaction – Chemical Class 03:30·      Sulfa and Sulfur – the Difference 04:20·      Therapeutic Class = Indication = What it’s for 05:20·      Same Druggists 06:10·      Mechanism of Action – Digging Deeper 06:50·      Multiple Mechanisms of Action 08:25·      Therapeutic Duplication 10:45·      Only One Chainsaw 11:20·      Controlled Substances 11:45·      Get in the Conversation! 13:15·      Be Your Own Detective 14:00Questions and comments to [email protected]

Summary:  The relatively recent release of Ingrezza and Austedo (2017) offer an option for the treatment of the abnormal involuntary movements associated with Huntington’s Disease and Tardive Dyskinesia (TD), a condition associated with the use of neuroleptics.  This episode addresses the multiple activities of dopamine, how neuroleptics work by blocking dopamine receptors, and how this may result in TD.  In turn, the presumed activity of Ingrezza and Austedo are discussed, potentially easing the distressing symptoms of TD.Topics:·      Involutary Movement 01:20·      AIMS 02:00·      Tardive Dyskinesia TD 02:30·      Risk-Benefit 04:00·      Dopamine 04:20·      Dopamine Receptor Blocking Agents (neuroleptics) 06:00·      Risk of TD (Haldol, Prolixin, Reglan…) 07:40·      Ingrezza & Austedo for TD 10:00·      Dopamine & Acetylcholine Balance 11:30·      Dopamine Effects 13:10·      Dopamine Neurotransmitter 15:20·      Ingrezza & Austedo Mechanism of Action 18:00·      TD Symptom Relief 19:00·      Ingrezza & Austedo Dosing, Side Effects, Precautions… 20:00·      Drug-Drug Interactions 27:00 Questions and comments to [email protected]

Summary: Any job is made easier – or possible – by having the right tool for the job.  The same goes for getting the most benefit out of your drug(s) and minimizing the risks of your medication.  The right tool for this is at your fingertips…actually, it includes your fingertips:  it’s you, being a drug detective. Topics:·      The Right Tool 01:00·      Get in the Game 01:55·      Evidence Based Medicine 02:25·      Patient Values 03:00·      Utilize Your Pharmacist 03:45·      Drug Detective – Journal 04:35·      Deep Dive 05:50 Questions and comments to [email protected]

Summary: This episode looks at the relatively widespread use of Trazodone for insomnia, an off-label drug use of this antidepressant.  Currently, there is some disagreement in the medical community on Trazodone’s place in the treatment of insomnia, but that does not necessarily make its use wrong or inappropriate.  While that discussion goes on, what can you do about it’s off-label use now?  Listen.     Topics:·      Twenty Rx FDA Approved Meds for Insomnia 02:30·      Trazodone not a DEA Controlled Substance 03:00·      Benzodiazepine Use History 03:30·      1987-1996 Trazodone Use Up, Benzo Use Down 04:00·      Why Trazodone? 05:00·      Evidence Based Medicine 05:30·      Quality of Evidence 06:15·      What Can You Do? 09:30·      Risk-Benefit 11:00·      Drug Journal 11:15·      Participate 11:30    Questions and comments to [email protected]

Summary:  A listener shares his experience with the treatment of his Prostate Cancer, from the initial diagnosis, research into the best treatment for himself, his strict adherence to this treatment, and his continuing follow-up as he is now seven years cancer-free.  This discussion attempts to clarify some of the terminology encountered in this listener’s journey. Topics:·       Treatment Options 01:50·       Wait and Watch·       Surgery·       Hormone Therapy·       Radiation Therapy·       Immunotherapy·       Do Research – Support Groups 04:00·       Questions When Told You Have Prostate Cancer 05:00·       Signs & Symptoms same as BPH 07:00·       Questions When Deciding on Treatment Plan 08:00·       Biopsy 10:00·       Anti-androgen 11:00·       Radiation (Brachytherapy) 11:20·       Quality of Life 16:50·       Attitude? 17:30·       Gleason Score 18:00·       Talk to People – MD, Support Group 20:00·       Follow-up With MD·       Resource:  American Cancer Society 22:40 Questions and comments to [email protected]

 Summary:  Sometimes when you start a medication, you first might have to adjust to the idea of taking a drug every day, and then to the reality of its effects upon your body and mind.  But this episode is about another step that you might want to add to this scene:  monitoring and then communicating with your healthcare provider.  When was the last time your doctor called to see how you were feeling?  It’s you who has to start this communication, and with this interaction, you might just find the drugs being adjusted to you. Topics:·      Shared Decision Making 01:50·      Staying In the Game 02:10·      Supplements and OTC’s 02:45·      Adjusting the Drug to You 03:00·      Dosage? 05:15·      ACE Inhibitors to ARB’s 06:10·      Clarifying Options 06:45·      Clinical Parameters 08:20·      Reporting Side Effects 09:15·      It’s About You 10:10·      Lithium Carbonate & Table Salt 10:40·      Fine Tune Your Drugs to You 12:15  Questions and comments to [email protected]

Summary:  The balance of the flora in the gut is essential to maintaining a healthy barrier between what’s in your GI tract and what’s in your bloodstream.  This episode addresses how broad-spectrum antibiotics can cause C. Diff, the dramatic effects of this and how it is treated.  Also discussed is how diet, alcohol and some drugs may affect the balance and diversity of the microbiome in your, thereby causing Leaky Gut (allowing contents of gut into the body), which in turn may cause or aggravate a variety of conditions, from autoimmune disorders to diabetes to Alzheimer’s.    Topics:·       Gut-Brain Connection 01:30·       Finding the Mother Tree 03:00·       Antibiotics & C. Diff 04:40·       C. Diff Treatment with Drugs 06:15·       C. Diff Treatment with Fecal Transplant 07:50·       Prebiotics 08:45·       Antibiotic Stewardship 09:25·       Leaky Gut 09:50·       Leaky Gut Causes – Diet & Alcohol 15:10·       Leaky Gut Causes – Laxatives, Proton Pump Inhibitors, NSAIDS, Statins? 17:90·       Gut Serotonin Production 21:30·       Journal & Participate 23:30·       Conditions Caused by Leaky Gut 26:00·       Heart Disease? ·       Autoimmune Diseases ·       Alzheimer’s·       Dietician & Nutritionist Resources 30:00·       Diet & Med-Gut Connections – Pay Attention & Participate 32:40    Questions and comments to [email protected]