Discussions that mention requip

Pain Management board

Hey Streetcar, This such a common question, perhaps the best way to settle this with your daughter who with even a certified tech program has no clinical knowledge of how these meds work. Have her ask her pharmacist, If he had a heart or kidney transplant would he use generic immune suppressors or heart medications.

Cardiologist flat out won't prescribe certain drugs in generic forms, due to the differences whatever they are, a transplant doc will not prescribe generic medication to prevent organ rejections.

If the docs that treat these patient populations and prescribe these meds and read the journals and have been notified of the rejection and death rates from using generics Vs name brand won't prescribe them and the pharmacist knows that, why do they insist on the same BS we hear all the time..

Poor quality control and allowable variances do make a difference, why do pharmacists, some docs and technicians believe generics are all the same when there are 6 different rating codes for a generic.

I can't post names or links, But my brother has PhD's in microbiology and immunology, was the FDA liaison and quality control for the special blood products division for the company that made it's name with the invention of aspirin. He personally ran a GCMS on a methadose tab for me and it came back with less than 8.5 mgs of methadone.

I don't want to insult your daughter or her education, I'm sure she's just trying to comfort you about medication and as every child is looking for their parent to be proud of what they are doing and their knowledge. The fact is, she's wrong. She hasn't taken the medications nor has had the training in chemistry to even explain what stereo chemistry is. Has she read a single medical journal? I hope she doesn't truly believ Oxycontin lasts 12 hours. :eek:

The FDA guidelines are not a couple pages long posted on the Internet. It's thousands of pages of text that she has never seen. I have access to every .gov and .edu link that my brother has. Much more than the averrage bear can access and the allowable variations are there.

Just think about mass producing a pill that contains say .125mgs of Requip, do she really think a computerized machine can mass produce on such a huge scale without some variations. Does she know what class of drugs Requip is in? But she's an expert on every generic manufacturer that makes the meeds we take. Very humorous. It's OK, I remember being young and wanting to share what I had learned. She needs to keep an open mind, learn from the patients that refuse to take specific generics, learn from docs that write for name only and ask the pharmacist why he would do that and continue her on the job training.

She's discounting every patients experience and patient reporting is part of the entire medical process. Just because Methadone has a 20-30 hour half life, it doesn't mean you will absolutely get great results with BID dosing. Persoanlly I felt it wear off in 4-5 hours. That's also the standard dosing schedule for acute or hospice dosing. If it doesn't even reach half life untill 24 hours why the need to redose more frequently? Patients are wrong and docs are pharmacy techs are right? This is her chance to learn, not argue about something she has minmal training and experience with.

Knowledge comes from experience prescribing, patient reporting and experience with the medication. Not something they teach at any Certified tech programs. They don't go page by page through the PDR. They learn how insurance is billed, proper security procedures, DEA rules and regulations. But it certainly doesn't prepair them to have a discussion with the FDA or the CFO of a major pharmacuetical company. How many Pharma companies has she talked too? How many pharma reps?

She's passing on info taught by her pharmacist that is paid a bonus if the generic scripts exceed the name brand scripts. Her information is wrong.
Can she explain the difference between Oxycodone Hydrochloride,
Oxycodone Terephthalate or Hydrocodone HCL and hydrocodone biotartrate.

An even better way, In which she can see for herself. Have her pick up a name brand bottle of Tylox and compare it to the mellenckrodt version.

She can also do it with name brand Percodan and generic percodan. They teach her it's the same so they will tell patients it's the same so the pharmacist makes his generic bonus and maintains an enoromous profit margin.

I just ask my wife what the margin was to maintain their generic bonus, she managed for Rite aid, Eckerds and Revco for 7 years and unless the generic margin to name is 60% or higher they didn't get their bonus on generics which could reach up to $7500 per quater. It was my wifes job to gather that info for corporate headquaters, so off course they push generics, wouldn't you?
Technician are not to dispense medical or pharmacological advice.

I called the drug store the other day and ask if they had MS04 in 30 mg pills, she said what's that, what was after having talked to the pharmacist the day before and told she had plenty,The tech she said they didn't carry it. The pharmacy doesn't carry morphine?

Same thing has happened with methadone, what's that ?. If your daughter has a degree in chemistry, microbiology, or pharmacology I would love to have a chat with her, But she's basicaly spewing the information fed to her by pharmacist to ensure their quarterly bonus.

The talks I have with nurse practionieers are so rediculous it's amazing. Even docs and dentists really have minimal knowledge of pain management medications. 3 hours of their medical school is devoted to pain management, 3 HOURS A title does not instill knowledge.

Unfortunately she will pick up the attitudes of the pharmacist she works with. If her pharmacist insist all CP patients are drug addicts , that's a larger and harder battle you have down the road. Nip it in the bud and tell her you will discuss your meds when she becomes a pharmacist, chemist or works for the manufacturer of the meds you take, or when she has actually taken a med you take and found it not inferrior.

Tell her to ask her pharmacist about the transplant and cardaiac drugs, would he use them himself, and why not if they are all the same.

Let her research. You won't end up with egg on your face. Nobody works with a 0 margin of error, even the FDA acknowldges this. If a doctor had to have a 100% on every board he took we would have no doctors, same with pharmacy and nursing boards, so what part of these exams did they get wrong and what does it mean to the patients they treat. Kinda scarry you may have a problem the doc, pharmacist or nurse has no knowledge off or is incorrect about. Not that they will admit it. But it sure makes you wonder. LOL
Take care, Dave