Why did some pills suddenly get so expensive?

Well, I had been wondering that myself.

It appears that the FDA is trying to eliminate very old drugs that are widely used in conditions for which they were actually never proved to be safe and effective.

This in itself is not a bad idea. For example, a look into whether childrens' over-the-counter cough and cold formulas really help or not has shown not only that they don't help to relieve cold symptoms in children, they can also cause serious side-effects such as seizures. This has led to efforts by family doctors and pediatricians to let parents know this and to use more supportive home treatment than over-the-counter medicines.

On the other hand, this has led drug companies to respond in unfortunately predictable ways. This story explains why colchicine (used for decades to relieve or prevent severe gout pain) went suddenly from 10 cents/pill to $5/pill.

It is also probably why you can't get quinine pills for leg cramps anymore. It was never actually tested for any condition but malaria. My guess is that the companies that make it don't want to go through the trouble and expense of testing it for leg cramps and simply withdrew it.

Radiation Exposure

While I trust that the fax from Grandpa's Pharmacy offering to sell me and my office staff much-sought-after potassium iodide at the bargain rate of $60 is well intended, I doubt that it will be necessary. Apparently, there's been a run on the supply in the US, especially on the West Coast.

Potassium iodide can help to displace radioactive iodine from being taken up by the thyroid gland in the event of exposure to it, but would have to be taken at least 6 hours before exposure. Even given the US NRC recommending US citizens in Japan evacuate from within 50 miles of the troubled reactor, the exposure levels on the US mainland over 5,000 miles away is going to be just about nil. Overall, the smart money in avoiding exposure to radioactive iodine will be avoiding drinking milk from northeast Japan.

Some interesting reading on the subject:

• ProPublica has a nice reading list from a variety of news sources covering basic background, up-to-the-minute liveblogs and twitter feeds, and the public health aspects of radiation exposure.
• MSNBC (h/t to Boing Boing) shows a ranking of US nuclear power plants at risk for quake damage causing a core meltdown. (Hint: the most at-risk are not in California)
• For those concerned about TEOTWAWKI (the end of the world as we know it), Medscape has a very technical discussion of nuclear and radiologic decontamination including a discussion of potassium iodide. Who knew Mylanta and Maalox can help to reduce absorption of strontium and radium? (Dose: 100cc by mouth ASAP upon exposure)
  
• For an interesting and lighter side note, Slate discusses why there is so little looting going on in Japan right now.
  

Interesting conversation over breakfast with my daughter this morning about how to decide on your livelihood. She is a high school freshman who wants to contribute to the world, have a comfortable salary, have a family, travel and enjoy what she does for a living. Indeed, don't we all?

Interesting she should ask (and believe me, I'm glad she's asking), since there have been some interesting reads in the news on this very subject.

This article in the Harvard Business Review questions the practice of "business as usual" and re-frames the question for the future as "Does what you do have a point- one that matters to people, society, nature and the future?"

The next people to be displaced by computerization (not so much by off-shoring) are attorneys. Wow. Just wow.

Staying cool under pressure is somewhat genetic, but more so environmental. And the good news is, it can be taught!