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Boston Bombing Suspect Sedated and Communicating
We continue to follow the reports of the medical care being given by Boston bombing suspect Dzhokhar Tsaranaev. The patient is reportedly intubated and sedated but able to communicate with investigators via writing. CNN has a report that discusses this written in part by health reporter Elizabeth Cohen that uses quotes from several physicians commenting on the case. Unfortunately, these characterizations are inaccurate and wrong and were given by two physicians (Dr. Albert Wu and Dr. Corey Siegel) that obviously do not routinely sedate patients trauma patients in an ICU. Only Dr. Athos Rassias of Dartmouth, who is Directo...
Source: Inside Surgery - April 22, 2013 Category: Surgeons Authors: Editor Tags: Musings Albert Wu bomb breathing communicating Corey Siegel ICU propofol Ramsey sedation suspect Tsarnaev Source Type: blogs

FDA Drug Shortages: Fundamental Problem is the Inability for the Market to Observe and Reward Quality
Conclusion Ultimately, the FDA officials argued that “the fundamental problem with injectible shortages is insufficient market reward for quality (including reliability of production) stemming from the buyers’ inability to observe it.” This in turn gives manufacturers strong incentives to minimize quality system investments, especially when faced with pressures brought about by new production opportunities, aging facilities, and the recent economic downturn. Until new incentives are provided to improve quality, it is uncertain whether generic-injectable makers will adequately address quality issues. (Source: Policy and Medicine)
Source: Policy and Medicine - April 12, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs

Drug Shortages: Despite Gains, Many Drugs are Still in Short Supply
A recent article from Bloomberg noted that “as shortages of sterile injectables persist, the makeup of that part of the industry is in flux.” To address the current marketplace struggles, Mylan has agreed to buy Agila Specialties, the injectables unit of Strides Arcolab, for $1.6 billion, and analysts think Claris Lifesciences could be next, saying “it is a matter of supply and demand.” Claris has five (5) FDA-sanctioned manufacturing facilities in Ahmedabad, and an analyst tells Bloomberg it might be worth about $500 million. Claris has “a ready-made facility,” Ranjit Kapadia, an analyst at Centr...
Source: Policy and Medicine - April 8, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs

The LITFL Review 092
Welcome to the mind-blowing 92nd edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around. The Most Fair Dinkum Ripper Beaut of the Week The Short Coat Top Spot this week is a ripper By Lauren looking at hypertension in the ED. Check our M...
Source: Life in the Fast Lane - January 23, 2013 Category: Emergency Medicine Doctors Authors: Kane Guthrie Tags: Education Emergency Medicine Featured Intensive Care LITFL review Trauma LITFL R/V Source Type: blogs

FDA Updates PDUFA Goals: NDA’s, BLA’s and REMS
The Food and Drug Administration (FDA) recently gave three presentations from the Centers for Drug Evaluation and Research (CDER). The first presentation focused on New Drug Review and a 2012 Update from John K. Jenkins, MD, Director of the Office of New Drugs in CDER. The presentation was given at an FDA/CMS summit. Jenkins first began by addressing how CDER is doing with regards to meeting the Prescription Drug User Fee Act (PDUFA) goals for drug approval. He also gave an overview of the trends in new drug approvals, investigational new drug (IND) applications, New Molecular Entity (NME) submissions, and NME app...
Source: Policy and Medicine - January 9, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs

New Academic Year Thoughts
The academic year is well underway and thoughts now turn to the candidates that will be filing applications for graduate nurse anesthetists programs. For those that are thinking about or are applying this year here are a few tips from someone fresh in the mix. Dear David, Words cannot express the gratitude that I have for the invaluable shadow experience you presented me and all the words of encouragement you provided me. Forgive my redundancy, but thank you, thank you, thank you, thank you and thank you some more. My journey to become a CRNA started when I was just in my third semester of nursing school. During my...
Source: Nurse Anesthetist - December 29, 2012 Category: Nurses Authors: David Tags: General Student Life Source Type: blogs

Real Teens Ask: Is Propofol a Drug?
Since the death of Michael Jackson in 2009, “propofol” has been mentioned often in the news. The substance was found to be the cause of his death and was the center of the highly publicized trial of his doctor. So, it’s no surprise there is a lot of curiosity about propofol. NIDA received questions about it during last year’s Drug Facts Chat Day. During Chat Day, Cam from California asked about the basics— Is propofol a drug? Yes. Propofol is a common type of anesthetic—a drug that doctors use to “put people to sleep” for surgery. It is given to patients through an “intravenous drip,” (called an “IV�...
Source: NIDA Drugs and Health Blog - January 26, 2012 Category: Addiction Authors: Sara Bellum Source Type: blogs

the early results of Obamacare
I’ve been trying to avoid talking about health-care reform (or deform, if you want to be accurate) on here, because it makes me so angry that I’m virtually speechless. I’ve also stopped talking about politics with my liberal friends at work. I used to enjoy a friendly debate, but there’s nothing fun about the looming disaster. I can’t not talk about this any more. I just opened a mass email to all the physicians at my hospital, informing us that, in addition to compazine (a very basic anti-nausea medicine; cheaper and more effective than zofran, and less sedating than phenergan; my go-to drug ...
Source: Cut On The Dotted Line - December 23, 2009 Category: Surgery Authors: Dr. Alice Tags: politics Source Type: blogs

Diprivan (propofol) and Michael Jackson
Although Diprivan is widely used every day in hospitals and surgery centers across the United States, very few people, outside of medical personnel, were familiar with it or had even heard of it prior to its being found in Michael Jackson’s home after his untimely death. And while we still don’t yet know if it was related in any way to his death, many people want to know more about Diprivan and what its potential effects might have been. I worked for ICI, now Astra Zeneca, the pharmaceutical company that originally developed Diprivan, in the mid-80s during the time it was being prepared for market launch. I was...
Source: Dr. Z's Medical Report - July 9, 2009 Category: Physicians With Health Advice Authors: Ed Zimney, MD Tags: Healthy Living alcohol anesthesia anesthesiologists Astra Zeneca availability blog dangereous Diprivan Diprivan safety Diprivan use Dr. Z's medical report drug Ed Zimney Everyday Health fatal hospital setting hospitals Source Type: blogs