Sanofi Fights Off Competition with the Release of Toujeo

Sanofi, a drug company in France is trying to get their new insulin, Toujeo approved by the FDA before their patent for the extremely popular Lantus, expires later this year. With the patent expiring, other drug companies like Lilly, and Merck are racing to come up with a cheaper version of the Sanofi original. The popularity of Lantus has given Sanofi a 15% share in the insulin market, the largest share of any single company.

They have been having some issues with the approval of Toujeo. Physicians have said that,while this new product is an improvement on Lantus, it isn't as large of an improvement that Lantus was when it was first released. This statement, especially since it was made by physicians, will discourage the prescribing of Toujeo since it will be more costly. Therefore, the future success of this insulin will depend on what the company chooses to set the price at, and if they can get it approved before the patent expires.

NSAIDS

I read a scary article today, saying that NSAIDS (non-steroidal anti-inflammatory drugs), that have been used to manage pain after heart attacks are actually boosting a patient's bleeding risk. They are also leading to increased opportunities to suffer another cardiovascular outcome, including death.  Even if the medication was only taken for less than seven days. 1/3 of our population suffering from heart related issues have prescriptions for these NSAIDS. Examples of NSAIDS include ibuprofen (Advil), and naproxen (Aleve).

The study recommended that doctors prescribe aspirin as well as clopidogrel which are also blood thinners.

Major, Minor

Most people understand my reasons for choosing pharmacy as my major, but they have had a harder time relating to my minor, Business Administration.

For me, it was a simple choice. In order to own a pharmacy in ND you must be a pharmacist with 51% ownership. This law gives the pharmacist the challenge of serving two distinctly different roles. I wanted to be prepared to take on both roles head first. It is important for me to feel that I am prepared to run a business, and I know that with the attainment of this minor I am well on my way.

Taking my business classes at NDSU also gives me a break from the endless science classes that I have taken. They can become exhausting at times, plus my business classes are very relatable!
My minor is also leading to some brilliant adventures within the college of business, studying abroad! I will write more at a later date, but I know it will be a trip of a lifetime!

Most Wanted?

Today I got finger printed. Its required by NDSU for the pharmacy program, it is such an odd and awkward process, but really funny. I had never been finger printed before so i wasn't really sure on what the process would be like.

The worst part was letting the printer take control. I always felt like I should help him roll my finger across the paper, but he said that wasn't a good idea. It would have smudged the paper and force me to start all over. When the process began I was doing pretty well, but towards the end I had to keep telling myself to let him do his job.   :)

They sent off all of my materials, the finger prints, a background check form, and a few other things. I know they'll be clean, but for some reason I'm scared they won't be?! I'm sure its just the getting accepted nerves? Who knows?

On a side note,  a little over 2 weeks from the interview!!!

EEK

ObamaCare

The Affordable Care Act is one confusing law, that people are either for, or against. A patient's healthcare plan is in control of what medications they can get and how they pay for those medications. I have been wanting to learn more about the Affordable Care Act for my interview preparations as well as for my own knowledge.

I read up on the Affordable Care Act on several websites, but there were some that made the topic much more simple than others. Obamacare facts was the most user friendly for me. My favorite part about the website? The simple videos they provide that clear up all your questions in about 5 minutes.

I have included the two videos that I watched. I appreciate their ability to explain the content in such a basic manner so that anyone could understand!

Health Insurance Explained

Get Ready for Obamacare

No Smoking

There is a new drug being tested that is getting better than expected results.

The drug Varenicline (Chantix) was being tested in a clinical trial to help smokers reduce the number of cigarettes they were smoking in order to help them quit within the next few years. The trial was more then successful as all the users who use Varenicline stopped smoking earlier than expected and were able to continue without smoking for a longer period of time. 

While smoking rates have decreased over the past few years, it would be great if we could eliminate it in the future. With drugs like Varenicline and Bupropion, as well as nicotine patches and gum we were getting closer. 

Smoking doesn't only affect the smoker, but everyone around them. The affects start small, like secondhand smoke, but can then increase to aftermath dealing with the loss of a loved one from lung cancer. I have experienced this situation personally, and it is one I wish I could have avoided.

The Great Immunization Debate

Lately, I cannot go on Facebook or read the newspaper without seeing a new article on the outbreak of measles all over the country. The majority of the outbreak is being spread by those that haven't been immunized.

Vaccinations can be a tough sell to new parents, but the truth is, they are absolutely necessary. Vaccinations came under fire in the late 2000's for being linked to autism. Numerous studies since then have proved otherwise, yet the stigma still stands. But why? Physicians and nurses have presented the information to new patients and they still choose not to follow their caregivers' orders.

Below is an article published on the Voices for Vaccines website. I believe it is an important read.
Children don't have a say in whether or not they will be vaccinated, which can lead to a sickly future...

http://www.voicesforvaccines.org/growing-up-unvaccinated/

interview questions

Since receiving my interview for pharmacy school I've been looking up some websites to gain some insight on what they may ask of me. I figured that they would be helpful for others, so I have decided to post them here!

http://www.studentdoctor.net/2013/12/medical-school-interviews-6-common-mistakes-that-admissions-officers-hate/

http://sciencepreps.iupui.edu/pharmacy-school-interview-questions

http://www.thepharmacistblog.com/2014/01/30/pharmacy-school-interview-questions/

pharmacy humor is my favorite humor

pharmacy/drug humor always makes me giggle. just as the semester is starting to get more stressful i thought i would post some pharmacy funnies :)

one step closer!

I did it! I got the interview!
I cannot believe my three years of hard work is coming down to these next three months. I still remember my freshman year at NDSU and making all these big plans for Pharmacy school not knowing what the future would bring. These three years have flown by so fast but I know I wouldn't have survived without my amazing family and friends.  They are forever reminding me that I CAN do this.

we're halfway there :)

Diabetes

I wanted to post a paper that I wrote my senior year of high school. Every article I have read on this topic still forgets to distinguish between the many different types of diabetes.

My brother has suffered from type one diabetes since he was seven. Everyone I encounter looks confused when I tell them he suffers from diabetes, because most see it as a disease that only occurs in those that are overweight. We all need to shed light on this disease that affects ALL people.

Ashlyn Riedesel

Advanced Comp

February 23, 2012

Compare/Contrast

Sooo, You Got It Because You’re Fat, Right?

            The effects of this disease are dangerous. Heart disease, stroke, high blood pressure, blindness, kidney disease and even amputation are all possible if you have diabetes (Diabetes Stats). There are two types of diabetes that are most common in our world. These two types, Type 1 and Type 2 are continually perplexed in society today.

            How many people actually have diabetes? Diabetes mellitus is a disease that affects 25.8 million people. In 2010 there were 1.9 million people just being diagnosed with the disease. Also, there are 79 million people who have the symptoms of becoming diabetic (Diabetes Stats).

            Erika Gebel described what diabetes is best with “ In simplest terms, diabetes means having too much of a kind of sugar in your blood.” This sugar is known as glucose, glucose enters the body as food and is then converted into glucose. The job of regulating the amount of glucose in the blood is job of insulin. It tells cells when it is the perfect time to take the glucose out of the blood so that the blood glucose level can return to normal. When a person has diabetes, there is either no insulin left in the body or very little depending on the type. Insulin must be injected into the body several times per day to regulate the glucose levels in the body (Gebel).

            Type 1 diabetes, which is also known as Juvenile Diabetes isn’t very common. Type 1 is an autoimmune disease, which means that the body starts attacking itself. In Type 1’s case, the body starts attacking the pancreas and its insulin producing cells. This disease can also come about from genetics and some environmental factors. The most important part of Type 1’s beginning is that is has nothing to do with a person’s lifestyle or their diet (Type 1..). If someone has Type 1 diabetes they do not have any insulin in their body whatsoever. The body has annihilated all of the insulin, and the body cannot reproduce it (Gebel).

 There are a profuse amount of symptoms that lead to the possibility of Type 1 diabetes. Drowsiness is one, constant drowsiness; falling asleep in the oddest of places, stairs, trailers, and bathrooms; anywhere. Other symptoms are: sudden vision changes, extreme thirst, increased appetite, frequent urination, fruity breath, sugar in urine, heavy breathing, stupor, and sudden weight loss (Type 1..).

Juvenile Diabetes became another name Type 1 because of who usually gets Type 1. Most are diagnosed when they are either children or teenagers, children as young as age two have been diagnosed. This makes it hard, as many of the young children do not understand why they have to be pricked and poked several times per day. It is hard to tell them why they cannot have a piece of cake at their own birthday because their blood sugar is too high. Also, they have resentment towards parents and other adults who administer their shots and finger pokes.

Type 1 diabetes needs to be treated 24/7. Poking the finger with a needle checks blood sugar and then blood is squeezed onto the meter. This will read what the blood sugar is. A shot of insulin then has to be injected into either the leg or arm; the dosing depends on whether there is a high or low blood sugar. The latest and greatest tool in treating Type 1 is the insulin pump.

            The insulin pump was invented in the 70’s but it really came into play around the 2000s. This device pumps insulin into the body constantly. The device is attached to the owner by flexible tubing and a set that goes into the skin. A diabetic enters in their blood sugar and the pump automatically starts pumping the perfect amount of insulin, it can also be arranged so insulin is pumped throughout the night to regulate blood sugar. An entire bottle of insulin is put into the device. The tubing and set has to be replaced every three days along with the insulin. The pump can be suspended when the owner is playing contact sports or swimming. This device has really changed the diabetic life. Type 1’s were used to a strict eating schedule because of the insulin shots; breakfast at 8:00, lunch at 11:30, snack at 3:15, dinner at 5 and another snack at 9. Straying from the schedule could give a diabetic out of control blood sugars. The pump gives its owner more flexibility; they can usually eat whenever they want and whatever they want because the pump will make up for it.

There are two types of blood sugar besides normal. When someone has low blood sugar, they become very confused and often whiny, if the blood sugar is low enough seizures could propel them into a coma and even death. To raise the low blood sugar usually a snack is eaten, unless the person is extremely ornery, then a glucagon shot or gel can be given.  When someone has a high blood sugar they often have frequent urination with glucose in it, and extreme thirst. To lower this a shot of insulin is given. The normal blood sugar range is between 100 and 140.

There can be many complications if Type 1 is not treated properly. Ketoacidosis or ketones are one major complication. Ketones are acids that can build up in the blood and then appear in urine when the body doesn’t have enough insulin. Ketones are more common when diabetics become sick. Diabetics test for ketones by urinating on a stick and then comparing the colors to the colors on the bottle. If it shows that there are ketones, it is an emergency and diabetics must be rushed to the emergency room as soon as possible. If diabetics do not take care of themselves there is a chance for amputations later in their lives; the most common amputations are of the lower limbs such as feet and toes (Diabetes Stats). People that develop Type 1 diabetes also have a greater chance of developing other autoimmune diseases such as thyroid disease, celiac disease and Addison’s disease (Other Diseases..).

The worst part about acquiring Type 1 is that as of right now there is no cure. There is nothing they can do to make the disease go away. It is stuck with them for life. A two year-old who develops the disease will not remember a life without needles. A teenager with the disease may long for the life they had before the disease took control. The Juvenile Diabetes Research Fund has their team on the hunt for a cure. Until then, all Type 1’s are poking, pricking, and hoping (Type 1..).

Type 2 diabetes is a lot less complex than Type 1. The disease is a lot more common than its diabetic friend too, 85% of diabetics have Type 2 diabetes. Their body has insulin inside it; it just cannot produce enough for the entire food intake. Their body could also be ignoring the insulin (Facts about..). When the cells start ignoring the insulin the glucose levels rise, along with the blood sugar, which then brings on Type 2 diabetes (Gebel). Type 2 diabetes has everything to do with a person’s diet and exercise level. According to the Gale Encyclopedia of Science “ Type 2 diabetes is associated with obesity, family history of the disease, prior history of gestational diabetes, impaired glucose intolerance, physical inactivity, and race/ethnicity.”

Before people are diagnosed with Type 2 they go through the pre-diabetes stage. This is when the body first starts ignoring the insulin. If it is caught early on the diagnosis can be totally reversed by the means of diet an increased activity level and some medication. If pre-diabetes is not reversed, diabetes will develop in 3 to 10 years (Diabetes Mellitus, Gale).  Other than pre-diabetes, which is discovered by a doctor, Type 2 doesn’t usually have symptoms. But if they do, they come about gradually and may include dry skin, frequent infections, fatigue, numbness or tingling in the hands or of the feet, slow healing time for wounds, and increased hunger/thirst.

People diagnosed with Type 2 are a variety of ages. Since the diagnosis of the disease is directly related to weight anyone who is obese has a chance of getting the disease.  A young child that is seven or eight could be diagnosed at the same time as their 65 year-old grandmother. There isn’t one age range that it ignores, but it commonly hits between the ages of 40 and 74 (Diabetes Mellitus, Gale). Females have a greater chance of developing the disease along with Latin Americans, Asian Americans, and Native Americans (Diabetes Mellitus, UXL).

Treatment for Type 2 is different than Type 1. Type 2ers have to check their blood sugar daily as well as take insulin like the Type 1 folks; however, they also will take an oral medication or two to help out the insulin. People with Type 2 also use different kinds of insulin. They can use both short-acting and long-acting insulin to help regulate their blood sugars. Type 2 diabetics must change their eating and exercising habits or else the disease will continue to worsen (Diabetes Mellitus, Gale). There isn’t a big game changer that helps life as a Type 2 diabetic; it is all about finding the right medicine that helps regulate the blood sugar. Each individual will have a different treatment plan and orders; the same medicine doesn’t work for everyone.

Type 2 diabetic’s biggest worry is their blood sugar. Their number tells them if their medicine is working right and if they are on the road to recovery. Type 2’s rarely worry about having a low blood sugar. It just simply doesn’t happen. They have a high blood sugar most of the time because of their food intake. Their ultimate goal is to bring that number down. They focus on being in the idyllic range of 100-140. Anything higher than 160 is considered high blood sugar so there is not much room for error.

Complications arise if Type 2 is not managed properly. People with Type 2 may develop eye problems; however, there are no symptoms for them, so eyes need to be checked regularly. Feet issues can also develop; they may acquire nerve damages and have poor circulation. Amputation of the lower limbs is also possible for Type 2 diabetics. Fighting infections is tough for people suffering from Type 2. Since they are already overweight, they chances of having a high blood pressure and high cholesterol are also there. Heart disease and strokes are a major thing that diabetics have to be aware of. Type 2 diabetics can enter a coma if their blood sugar becomes to high and the ending result of this could be death (Diabetes Mellitus, Gale).

The best part about Type 2 diabetes is that it can be cured. If the diabetic creates and sticks to a healthy diet and exercise plan and they take their medication the disease can be reversed. It is a happy day for those who struggle with Type 2. Although, it can be cured the disease can also come back. People can go back and forth from showing no symptoms of Type 2 to having legitimate Type 2. Once they are clear of all symptoms they are told to stick with that plan so the disease wont come back into their lives.

Diabetes is a game changer. It changes millions of lives every year. The two types couldn’t be any more different, but they both have sufferers looking towards a common goal. To find a cure for all who suffer from the disease. The dangerous effects could be blown out the window with just a simple pill. Wouldn’t that be nice?

Works Cited

“Diabetes Mellitus.” The Gale Encyclopedia of Science. Ed. K. Lee Lerner and Brenda Wilmoth Lerner. 4^th ed. Detroit: Gale, 2008. Gale Student Resources In Context. Web. 15 Feb. 2012

“Diabetes Mellitus.” U*X*L Encyclopedia of Science. U*X*L, 2007. Gale Student Resources In Context. Web. 15 Feb. 2012.

“Diabetes Statistics.” Diabetes.org. American Diabetes Association, 2012. Web. 15 Feb. 2012.

“Facts About Type 2.” Diabetes.org. American Diabetes Association, 2012. Web. 28 Feb. 2012.

Gebel, Erika. “What Is Diabetes?.” Diabetes Forecast. 01 Apr. 2008: 48. eLibrary. Web. 15 Feb. 2012.

“Other Diseases That Are More Common in People With Type 1 Diabetes.”  Kidshealth.org. Nemours, 2012. Web. 27 Feb. 2012.

“Type 1 Diabetes Facts.” JDRF.org. Juvenile Diabetes Research Foundation, Dec. 2011. Web. 17 Feb. 2012.

Pressure. Pressing Down On Me

I read an article the other day that talked about the stress that all pharmacy employees face in their day-to-day work environment. The article mentioned that after a stressful situation it is best to take a break because the pharmacist or other pharmacy employee is a lot more likely to make a mistake after the confrontation. It also mentioned that not taking a break can lead to job un-satisfaction. Most of my experience has been in a retail pharmacy environment. Since I started there I have developed a set of tools to prevent stress, and in the unpreventable times, a way to prevent it from getting me down.

To Prevent Stress:

1.   Ask questions! So many errors that lead to stressful situations can be prevented if we all ask questions. I ask my co-workers first for insight into my problems, and if they cannot help me solve it I will ask the Pharmacist. 
2.   Let it Go. If a confrontation occurs between my fellow co-workers I will be the first to forgive and move on. Letting things continue to boil is bad for the entire work environment and affects all staff, not just the two involved. Most pharmacies are in very tight quarters and there is no avoiding people, the longer the argument, the more awkward it becomes. 
3.  Don't bring work home, and home to work. It’s as simple as that.
4. Don't rush. When the pharmacy gets really busy employees tend to get a little on edge and push for faster filling and imputing. Everything seems to get a little chaotic. These are when mistakes occur. Mistakes result in more time pushing everything back further, it is important to work quickly but maintain accuracy, once you lose that accuracy it won't matter how quickly you can fill a prescription. The one medication that was inaccurate may end up costing someone their life. 

In stressful situations:

1. Do not lose your cool. I have been yelled and cursed at, but remain stoic. The moment you escalate your voice to that of a customer, you are officially in deep water. Arguing with the customer can result in the loss of a job, and even a career in that field. It is important to be patient and just allow the customer to express himself or herself. 
2. Do not take the confrontation personally. The escalated conversion may be the result of any combination of things. Most patients are coming to the pharmacy in order to get medication to help them feel better, when we're sick we often times feel grumpy and upset. It is important to be empathetic and realize it is not aimed directly at you, but rather the situation you are apart of.

Don't forget to smile and realize that you have one of the most rewarding jobs in the world! :)