Stims and supps
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18 members have voted
Coffee is a stimulant I believe and its pro's and con's have been discussed here at length.
I'm more interested to find out about supplement and vitamin usage. Do you use supplements or vitamins on a daily basis? Are the supplements that help you improve your concentration while playing a long stint of VP or blackjack?
What about help with sleep? Do you require supplements to help with quality of sleep?
I am embarking on an intense diet to try and shed some pounds before I head home. I will also be taking some natural testosterone as I'm a male over 35 years of age. It is a vegetable based product which has received some good reviews online. I will also increase my daily dosage of Omega III, Vitamin B12 and a multi-vitamin.
Do you think all supplements and vitamins are a waste of time or are there some that help you in your daily life?
Quote: sodawaterthere is an entire chapter in ian anderson's book about this. he is obsessed with vitamins and other "natural" health products. i am not convinced but it seems to be working for him.
Soda, there are hundreds of reports that show that vitamins are a waste of time as you get all the vitamins you require from food. The synthetic or "man made" ones just doesn't cut it apparently.
I think supplements are more functional as it usually simulates something that your body doesn't absolutely need to exist but rather something that allows some part of your body to work better because of it.
Anybody who has played VP for 8 to 10 hours straight can't tell me they don't get tired and lose focus somewhere through the process. Wonder if something might help?
Quote: rudeboyoiFor a prescription stimulant, get a script for adderal. Its very popular among college students and poker players. You can put in marathon sessions with intense concentration and focus. For an OTC stimulant, most of the stuff that you can buy is prob more of a placebo effect than anything. Ephedrine is an OTC stimulant that does work however. Most of it has been taken off the market but you can still find it in OTC asthma medication like primatene.
That is strange as Ephadrine is now a schedule 1 drug I believe? Anything that contains ephadrine is no longer OTC. Seems like there are still some available oout there?
I would never play such long sessions of anything but I knew there had to be something out there that will increase concentration. I wasn't thinking adderal though as I was more thinking along the lines of supplements. Kinda like Ginko Baloba or so.
Quote: rudeboyoiI'd say with gingko baloba the belief that it improves concentration has a more profound effect than it actually improving your concentration to any measurable degree. You feel something like adderal immediately work but something like gingko its supposed to have an effect after taking it regularly over an extended period of time so difficult to determine if its having any real effect besides in simply believing it does.
That makes sense however the adderal could be addictive where the Ginko perhaps may not be?
You can get VERY hooked on stimulants but you don't get hooked on supplements. Perhaps you can get hooked on the results of the supps but not the supps themselves I don't think.
It used to be that doctors all thought "extra" vitamins was a nonsense concept and that any "extra" simply improved the quality of the sewers since you pissed out "extra vitamins".
Less and less is this the proper view.... however vitamins have multiple roles and people have multiple nutritional states.
Most drugs are vitamin analogs. You can patent something that looks like a vitamin, you can't patent the vitamin.
Most hormones are in feedback systems... often two way or three way loops.
IF you increase your testosterone with a shot of testosterone... your body gets the feedback message and your testes will produce less. This is NOT what you want because once they get that message they keep obeying it.
Get your various testosterone levels tested and compared to healthy men in your age bracket. The Dutch study on non obese non diabetic males is usually best but there are other issues to determine which is best for you. For various political and financial reasons just about everybody tests "normal"... it means nothing. A man in the bottom five percentile will test "normal" as will someone in the top five percentile.
Some vitamin combinations fight against cancers some actually aid tumor growth. Be careful.
Exercise is the best diet aid and best weight aid. If you lower your testosterone you lower your muscle mass and what are you going to be exercising with?
Quote: FleaStiffWhoa there.
It used to be that doctors all thought "extra" vitamins was a nonsense concept and that any "extra" simply improved the quality of the sewers since you pissed out "extra vitamins".
Less and less is this the proper view.... however vitamins have multiple roles and people have multiple nutritional states.
Most drugs are vitamin analogs. You can patent something that looks like a vitamin, you can't patent the vitamin.
Most hormones are in feedback systems... often two way or three way loops.
IF you increase your testosterone with a shot of testosterone... your body gets the feedback message and your testes will produce less. This is NOT what you want because once they get that message they keep obeying it.
Get your various testosterone levels tested and compared to healthy men in your age bracket. The Dutch study on non obese non diabetic males is usually best but there are other issues to determine which is best for you. For various political and financial reasons just about everybody tests "normal"... it means nothing. A man in the bottom five percentile will test "normal" as will someone in the top five percentile.
Some vitamin combinations fight against cancers some actually aid tumor growth. Be careful.
Exercise is the best diet aid and best weight aid. If you lower your testosterone you lower your muscle mass and what are you going to be exercising with?
Thanks for the comments Flea. I wasn't really highlighting my own usage but since you have commented I would like to respond if I may :)
Natural testosterone "boosters" don't create testosterone in the body (which, I agree, would shut down production), they simply aid your body with its natural testosterone production. Injecting or introducing a "syntehtic" is a different story. That happens, I would assume with steriod use or with testosterone replacement therapy. Neither of those things is a very good thing I would assume, one medial and one just plain stupid :)
It is a medical fact that the body produces less and less testosterone the older it gets or it vallies out at a certain age. I have been tested and found a little low but nothing to worry about as it is natural to be lower at my age. Problem is I want to still enjoy hiking, the gym, playing golf, bike riding, canoeing and not to mention fornicating but in order for my body not to give me the middle finger, I would need to eat right, excercise at least 3 times a week and take the occasional supplement.
Not a bad trade off for being able to remain active?
Of course if you identify a deficiency, then supplementation may be appropriate. A possible example would be vitamin D during winter if you don't live in Vegas.
But it should always be considered that supplementation is not risk-free.
The doctor should have a diagnosis on file for a condition like attention deficit, or narcolepsy. For someone who just gets tired alot...adderall is not going to be prescribed. Every other person comes into the doctors office saying they need more energy, they are tired. That is usually a function of a stressfull job, working more hours, not getting enough sleep, and not eating right. Adderall is not prescribed for these people.
One bit of new research has shown that "sleepng cool" is essential for proper sleep. In order to get the most restfull sleep you need to get into deep sleep...and the warmer the body....the less deep sleep you get. So if you like to bundle up in the winter very warmly....or in the summer sleep in heat......you can feel tired in the morning. You can get 8 hours of sleep...but u need the right kind of sleep.
It was asked what can help you sleep. Just plain generic benadryl works for most.In fact most hospitals use it for people who cant sleep in those strange surroundngs. Of course there are contraindications, like people with prostate issues shouldnt for example...so check with md or the pharmacist where you get your meds. Most of the "PM" sleeping meds are just antihistamines like benadryl....except that they charge you more because i guess the population will think that "sleeping pills" are worth more.
As far as vitamins "giving you energy".....not a chance. Well a small chance.....if you have a vitamin/mineral deficiency disease...then of course they are valuable. If you are diagnosed with iron deficientcy anemia...of course taking iron will give you energy by treating the anemia.
In general I dont reccomend vitamins, unless someone is on a diet where certain food groups are ignored. During cough and cold season, vitamin C can be useful, as its water soluable and excess is eliminated easily. Again there are even contraindications for vit C...where people with gout can get episodes from the acidic vitamin C.
But in the end, the average person who has no disease that could cause fatigue....doesnt need vitamins in order to get more energy...they need a lifestyle change instead. Better work/life balance and better sleep. And that doesnt come in a pill
and one last thing....its tireing to carry around alot of excess weight. So another lifestyle change is to eaat better , excersize and lose weight. And if you are looking for a pill to melt away your fat.....well let me know when you find one that works....i could use it.
Quote: LarrySFirst of all...you wont be able to get your doctor to write for adderall to help with your concentration. It is A CII drug, and has the highest degree of monitoring.
The doctor should have a diagnosis on file for a condition like attention deficit, or narcolepsy. For someone who just gets tired alot...adderall is not going to be prescribed. Every other person comes into the doctors office saying they need more energy, they are tired. That is usually a function of a stressfull job, working more hours, not getting enough sleep, and not eating right. Adderall is not prescribed for these people.
One bit of new research has shown that "sleepng cool" is essential for proper sleep. In order to get the most restfull sleep you need to get into deep sleep...and the warmer the body....the less deep sleep you get. So if you like to bundle up in the winter very warmly....or in the summer sleep in heat......you can feel tired in the morning. You can get 8 hours of sleep...but u need the right kind of sleep.
It was asked what can help you sleep. Just plain generic benadryl works for most.In fact most hospitals use it for people who cant sleep in those strange surroundngs. Of course there are contraindications, like people with prostate issues shouldnt for example...so check with md or the pharmacist where you get your meds. Most of the "PM" sleeping meds are just antihistamines like benadryl....except that they charge you more because i guess the population will think that "sleeping pills" are worth more.
As far as vitamins "giving you energy".....not a chance. Well a small chance.....if you have a vitamin/mineral deficiency disease...then of course they are valuable. If you are diagnosed with iron deficientcy anemia...of course taking iron will give you energy by treating the anemia.
In general I dont reccomend vitamins, unless someone is on a diet where certain food groups are ignored. During cough and cold season, vitamin C can be useful, as its water soluable and excess is eliminated easily. Again there are even contraindications for vit C...where people with gout can get episodes from the acidic vitamin C.
But in the end, the average person who has no disease that could cause fatigue....doesnt need vitamins in order to get more energy...they need a lifestyle change instead. Better work/life balance and better sleep. And that doesnt come in a pill
and one last thing....its tireing to carry around alot of excess weight. So another lifestyle change is to eaat better , excersize and lose weight. And if you are looking for a pill to melt away your fat.....well let me know when you find one that works....i could use it.
Good answer Larry. What is your opinion on supplements? Same as vitamins?
Quote: TomspurGood answer Larry. What is your opinion on supplements? Same as vitamins?
I am no expert on alot of suppliments and herbal remedies.
Fish oil/omega has been shown long term to lessen the process of hardening of the arteries. Its a long term fix..not a short term fix.
glucosamine/condroiton...has shown to have a limited effect on joints and arthritis..if taken long term. Not a healing effect though/
melatonin...very mild for insomnia
there are some soy based products that had some success treating hot flashes in women.,,,mimicking estrogen based products.
other than the above.....I have seen little medical data on herbal products. It may be out there...i just havent seen it.
There are alot of herbal remedies which I cannot discount as chinese medicine has used many successfully...and I am not willing to discount them.
In fact most meds for alot fo disease states are synthetic versions of chemicals found in plants.
That being said...there is not any real research on interactions of herbal remidies with the thousands of otc and prescription medicines.
There are bigtime research on otc meds and prescription meds and their interaction with each other.
However if you want to know if melatonin will react with haldol.....who knows. Will Ginko interact with premarin...I have no idea.
The thing about herbal remedies and suppliments...is that they can make claims and are not held to the same scientific standards of OTC and prescription meds. They are NOT governed by the FDA. Their purity, effectiveness, content, dont have to meet standards set forth by the FDA for drugs.
There have been prescription drug factories that have been temporally closed down overseas in order to comply with FDA standards and practices....yet for herbal suppliments there are no FDA inspections.
I really cant say yes or no. If it were for me...I would choose ....no...I dont have faith in them right now.(other than the ones i mentioned above)
If I read some data.....i can change my mind.
but i need to see real double blind studies..
pharmacists to be a goldmine of useful info over the
years, far more than doctors.
Quote: LarrySOne bit of new research has shown that "sleepng cool" is essential for proper sleep. In order to get the most restfull sleep you need to get into deep sleep...
55 degrees F seems to be the perfect bedroom
temp for sleep. Yet people have their bedrooms
at 70 and sleep in pajamas and wonder why they
wake up constantly. It has to be a genetic thing,
central heating is very new to the human race,
barely 100 years old. For thousands of years we
slept cold at night and slept better for it. My dad
said the water in the wash bowl in their bedroom
always had a thin coat of ice in the morning when
he was a kid in the 20's.
Quote: EvenBob55 degrees F seems to be the perfect bedroom
temp for sleep. Yet people have their bedrooms
at 70 and sleep in pajamas and wonder why they
wake up constantly. It has to be a genetic thing,
central heating is very new to the human race,
barely 100 years old. For thousands of years we
slept cold at night and slept better for it. My dad
said the water in the wash bowl in their bedroom
always had a thin coat of ice in the morning when
he was a kid in the 20's.
The room temp in our house in winter (admittedly it is Vegas) is around 66. When going to bed all heating is switched off and when waking up the room temp is around 52. Sleep like a rock star even though our Chihuahua irritates the crap out of me by insisting on sleeping behind my butt!!! :)
You can buy a 60 pill bottle of B-Complex at WalMart for about five bucks. I take it twice a day.
Quote: mickeycrimmHave you ever seen those late night TV ads for diet pills, like "When is a diet pill worth $135 a bottle?" The current ads are for a version called Lipozene at $30 for your first months supply. The ad recommends two pills a day so that would be about 60 pills for the month. A friend of mine has always had weight issues. So he ordered the $135 version. But he is no dummy. By law they have to list the ingredients on the bottle. All they were selling was B-Complex. B-Complex is recommended by most nutritionists to help in weight loss as it keeps your metabolism going.
You can buy a 60 pill bottle of B-Complex at WalMart for about five bucks. I take it twice a day.
Yeah, buying supplements from these TV scammers is never a good idea, same as penis enhancement pills or pills that are supposed to attract the opposite sex to you....All a big scam if you ask me.
Quote: EvenBobLarry, got an opinion on CoQ10? I've found
pharmacists to be a goldmine of useful info over the
years, far more than doctors.
the upside of Q10 is definately worthwhile compared to any minor downside. Cardiologists often suggest patients take it if they are on statin cholesterol meds(which reduce the production of coq10). And there may be benefit for heart failure patients.
Very little data on cancer, even though many cancer patients have lower levels.but there has not been a cause/effect established.
can be helpful for people with boarderline high blood pressure. If they can reduce weight, cut out salt, they can lower pressure to normal. Q10 helps slightly as well.
So if it means going on prescription meds for hypertension...or doing more naturally with diet, exercize and Q10....then thats the way to go.
. Its natural of course and is found in some fish, and some meats and oils.
However I do not recommend something like this for anyone with any disease state unless their MD knows about it. There have been liver enzyme issues that havent been fully studied in doses over 200 mg.
And also some insomnia has been seen.
self treating with anything for a serious disease state is not something a pharmacist would usually get involved with
But for perfectly healthy people who want to take small doses its fine.
Quote: EvenBobLarry, got an opinion on CoQ10? I've found
pharmacists to be a goldmine of useful info over the
years, far more than doctors.
Really? One thing that I learned a long time ago is to never trust a pharmacist or a nurse for medical advice. They are simply not trained to give it.
I trust pharmacists to be able to catch adverse drug interactions; that's it. They have no clue how effective a certain drug is. Nurses are experts in patient care (I generally wouldn't want a doctor to give me a shot -- they are terrible at it and it will hurt like hell) but I learned long ago to ignore anything diagnostic that nurses say.
Everyone who works in the medical field likes to think that they know as much as the highly-paid doctor, but there is a reason that doctors make the big bucks (and had to go to school for so long). You may as well ask a dealer for advice on how to play your blackjack hand.
Have no trouble sleeping ( probably not a guilty conscience ? ) Most of the guys I grew up with died of cancer or lead poisoning.
Saw on TV today CVS pharmacy to quit selling cigarettes and give up 2 Billion in annual sales !
Quote: AxiomOfChoiceReally? One thing that I learned a long time ago is to never trust a pharmacist or a nurse for medical advice. ..
Pity you, then. In the last 30 years the pharm's
I deal with are extremely knowledgeable about
the drugs they dispense, way more than the
doc's are. Pharm's deal with drugs all day every
day, doc's look things up and write scripts. I
never trust a doc on drugs anymore, I use the
net and ask my pharm before I do anything.
Last year I needed an antibiotic and got a script
for Cipro. Made by Bayer, it's one of the most
prescribed in the world, if not the most. I looked
on the net and OMG, there are law firms that
handle nothing but Cipro cases. This stuff can
really mess you up if your system can't handle
it. My pharm guy said no way he would take it,
but he's sells it all day long.
I went back and told my doc and got another
brand. He said he's never had any complaints
about Cipro, and still scripts it today. There are
people who have gone blind from one dose of
it, or been crippled for life because it destroyed
their tendon. Bayer just pays the lawsuits and
this doesn't get much press. You can't know you're
one of the people who will have an adverse reaction
until you actually take it. No thanks.
My Dr tells me to take a baby aspirin and 400 iu of vitamin E every day since I had 2 angioplasties.
However you would be surprised what goes on behind the scenes before you get your prescription in your hands, The phone calls that gets placed to doctors questioning the efficacy of the directions, the strength, the drug. As a professional we do not crow to the patient "your doctor wrote directions that are innappropriate, or a strength for your child that is not appropriate, or a drug interraction that was missed. Plus try calling up a doctor that you dont go to and try to ask him a question for free. Or even a doctor that you do go to.....try to get a question answered within minutes.
Pharmacy is a 6 year program concentrating on the drugs and their effects on the human body. Doctors have to have alot more on anatomy, and diagnosisng, mixed in....maybe the "drug" portion gets a little watered down
I tend not to generalize there are pharmacists with poorer knowledge than others...and doctors with poorer drug knowledge....I cant generalize. There are brilliant doctors as well.
Just because part of my day is spent correcting a doctors mistakes...dosent make me say "doctors dont know what they are doing". That would make one appear to be a baffoon.
Quote: EvenBobPharm's deal with drugs all day every day
That's like saying that blackjack dealers deal with cards all day long so they know whether you should hit or stand. I'm sure that there are pharmacists who would never take a certain drug. I had a blackjack dealer tell me that I shouldn't hit a 16 against a 7. The point is, just because they deal with the things all day long, doesn't make them experts.
If I want advice, I go to an expert. Doctors for medical advice. Lawyers for legal advice. I don't ask a legal secretary whether I should sue someone, and I don't ask a pharmacist how well a drug works -- they are simply not qualified to answer those questions, because they have not received the necessary training. I also don't ask the cabbie in Vegas for a good sports bet.
On the other hand, I WILL ask a pharmacist if I can take this drug with that one -- that is a question that they have been trained to answer.
Quote: LarryS
However you would be surprised what goes on behind the scenes before you get your prescription in your hands, The phone calls that gets placed to doctors questioning the efficacy of the directions, the strength, the drug.
I've known three women in my life who
were career nurses and they all say
the same thing about doctors: They make
tons of mistakes that the nurses and
pharms have to catch or they would be
killing people. Docs are overworked and
seldom keep up with whats going on.
I totally believe you have to call their office
all day long and correct what they wrote.
If you trust your doc completely and don't
double and triple check what he says and
does, hey, good luck with that.
My roommate in college was pharm and so was my maid of honor. They have both proven very knowledgable on effectiveness,interaction, and side effects. I think there are levels of both them and doctors, and it's worth knowing a good one.
Quote: EvenBobI've known three women in my life who
were career nurses and they all say
the same thing about doctors: They make
tons of mistakes that the nurses and
pharms have to catch or they would be
killing people.
Of course they do. Everyone in any profession thinks that they are in the most important role and their superiors are idiots.
But when it comes to actual medical advice, I've never had a doctor give me bad advice. I have had a nurse give me advice that would have left me in very bad shape for several months had I followed it. I ignored the nurse, saw the doctor, and, after talking to me for 30 seconds, he knew exactly what was wrong and gave me the correct diagnosis and prescription, and I was fine a week later.
Quote: beachbumbabs
My roommate in college was pharm and so was my maid of honor. They have both proven very knowledgable on effectiveness,interaction, and side effects. .
Absolutely. And you have to ask the actual
pharmacist, not the middle aged lady putting
the pills in the bottle and ringing up your
order. She's not the the pharm usually, she
just works there. She has a white coat on
and knows a lot, but you have to ask important
questions of the pharm themselves, there's
usually only one per store, unless it's a really
big place.
who do you think a doctor calls when they are stumped....cipro doesnt work, and patient is allergic to macrodantin, and doxycycline....what do you think?
I would think 6 years is sufficient to help the doc out.
A doctor doesnt even know "how well" a medication willwork for a specific person....its all trial and error. What works well for one person...is inadequate for another person.
Drug companies have recently been hindered on the kinds of gifts they could give prescribers. Up until just a ittle whle ago, you didnt know if you were taking a drug because it was the best for you, or because the doctor got a free trip to hawaii to attend "a seminar".
Still even now, sales reps from drug companies see doctors, and you dont know if a doctor is prescribing a med for you because its the best medication..or because the sales rep was very persuasive, and left off the downside of the drug when giving his pitch.
Pharmacists are impartial....unless they own the pharmacy..they dont personally make money when they give you a reccomendation. Sales reps generally stay away from pharmacies because the pharmacist is not partial to any specific therapy and do not write prescriptions.
If a doctor accepts blue cross......and they get a memo from blue cross that theyprefer they prescribe xyz drug istead of ABC drug in order to control costs...even though ABC drug is a little more effective.....who do you think will give you an unbiased truthful answer when u ask ..."i used to take ABC and now you are switching to xyz.......are they equal?".
I already, get that question when doctors unknowing write fir things not on the formulary...and I have to tell the patient I need to get it changed by md, or have the MD submit a prior authorization to give medical justificaton for insurance approval. And the patient asks that question...and I gve an honest answer, I have no ties to insurance companies as far as them deciding to keep me in their network. Doctors are under more strain...if they keep on insisting on the more expensive therapies...they can find themselves outside of the network.
Quote: AxiomOfChoiceand I don't ask a pharmacist how well a drug works -- they are simply not qualified to answer those questions, because they have not received the necessary training. .
Wow, are you joking? They're the ones who ARE qualified,
who do you think the docs ask, their nurses? That's what
pharms are trained for, you act like they went to school
for 6 years to learn how to put the pills in the bottle.
They're the experts in the field, everybody depends on them,
especially the doctors. A doc would be the last person I
would ask about a drug, he can't be expected to keep all
that info in his head. He can't possibly know all the interactions,
that's what pharms are for.
Quote: EvenBobWow, are you joking? They're the ones who ARE qualified,
who do you think the docs ask, their nurses? That's what
pharms are trained for, you act like they went to school
for 6 years to learn how to put the pills in the bottle.
They're the experts in the field, everybody depends on them,
especially the doctors. A doc would be the last person I
would ask about a drug, he can't be expected to keep all
that info in his head. He can't possibly know all the interactions,
that's what pharms are for.
Pharmacists are absolutely experts about interactions, and I any time I fill a prescription, or even buy over-the-counter stuff, I will ask the pharmacist about interactions. That's what they went to school for, and I trust their responses.
However, asking a pharmacist about the efficacy of a drug is way beyond their area of expertise. There is a reason that doctors are allowed to prescribe drugs and pharmacists are not.
Quote: AxiomOfChoicePharmacists are absolutely experts about interactions, and I any time I fill a prescription, or even buy over-the-counter stuff, I will ask the pharmacist about interactions. That's what they went to school for, and I trust their responses.
However, asking a pharmacist about the efficacy of a drug is way beyond their area of expertise. There is a reason that doctors are allowed to prescribe drugs and pharmacists are not.
absolutly false.
The reason pharmacists cannot prescribe is because they are not experts on diagnosisng disease or conditions.
If the doctor correctly diagnoses and prescribes a medication, the pharmacist is fully qualified to discuss anything related to the drug, efficacy, efficacy compared to other drugs available, side effects, how to take the med, drug interactions., drug/disease interactions.
But when it comes to diagnosing.....mds are the experts. And I am not minimizing that. The diagnosis is the most important step. If you want a pharmacist to diagnose something.....I agree...that is not their expertise and I would seek a physician.
Quote: Buzzard" That would make one appear to be a baffoon. " DAMN, if only I could be sure Mission was not watching !
its like grown ups are talking around the dining room table after a nice dinner sipping their coffee.....and the 6 year old kid walks up and says....look at me I can make fariting noises with my hand under my armpit.
now go away and let the grown ups talk...
we will call you when the ice cream is served
Quote: LarrySabsolutly false.
The reason pharmacists cannot prescribe is because they are not experts on diagnosisng disease or conditions.
If the doctor correctly diagnoses and prescribes a medication, the pharmacist is fully qualified to discuss anything related to the drug, efficacy, efficacy compared to other drugs available, side effects, how to take the med, drug interactions., drug/disease interactions.
But when it comes to diagnosing.....mds are the experts. And I am not minimizing that. The diagnosis is the most important step. If you want a pharmacist to diagnose something.....I agree...that is not their expertise and I would seek a physician.
If pharmacists are experts in efficacy compared to other drugs available, then how come they can't give you a different drug than the one that the doctor prescribed?
In other words, if the doctor diagnoses you with a disease, and prescribed drug A, how come the pharmacist can't say "drug B is more effective for that disease than drug A, so I'm going to give you drug B instead"?
The doctor is the only person who is legally allowed to make that decision, and is the only person who I'd trust with my health when it comes to making that decision.
Quote: AxiomOfChoiceIf pharmacists are experts in efficacy compared to other drugs available, then how come they can't give you a different drug than the one that the doctor prescribed?
In other words, if the doctor diagnoses you with a disease, and prescribed drug A, how come the pharmacist can't say "drug B is more effective for that disease than drug A, so I'm going to give you drug B instead"?
The doctor is the only person who is legally allowed to make that decision, and is the only person who I'd trust with my health when it comes to making that decision.
Because although we have knowledge of a more efficacious drug, the doctor is tied to a insurance company formulary. Also a doctor can lose his standing and patients if his charges are too high per patient. Doctors have to prescribe within the parameters of what the insurance companies allow.
Actually the insurance company decides what drugs are available for the doctor toprescribe. There are therapeutic committes in these insurance companies made up of doctors and pharmacists....that weight efficacy and cost in order to come up with a formulary for practitioners to pick from. So in a way pharmacists are involved in the process of selecting meds based on efficacy and cost....and balancing both. Therapeutic committees in insurance companies and in hospitals always have a pharmacist in it. It would be suicide for the organizaton not to.
If you think a pharmacist went through 6 yearsof just drug interaction classes....you are mistaken.
Quote: LarrySBecause although we have knowledge of a more efficacious drug, the doctor is tied to a insurance company formulary. Also a doctor can lose his standing and patients if his charges are too high per patient. Doctors have to prescribe within the parameters of what the insurance companies allow.
This has nothing to do with insurance. Even if I am paying out-of-pocket for my drugs, it's still illegal for a pharmacist to give me a different drug than the one that has been prescribed. Again, the doctor is the only one who is allowed to make that decision.
Quote: LarryS
Drug companies have recently been hindered on the kinds of gifts they could give prescribers. Up until just a ittle whle ago, you didnt know if you were taking a drug because it was the best for you, or because the doctor got a free trip to hawaii to attend "a seminar".
Still even now, sales reps from drug companies see doctors, and you dont know if a doctor is prescribing a med for you because its the best medication..or because the sales rep was very persuasive, and left off the downside of the drug when giving his pitch.
.
while waiting at the clinic I go to out here in Western Canada the sales rep for a drug company came in to SEE THE DOCTOR.... his doctors like bag was as full as it could possibly be ... 15 minutes later when he left it was now empty. Clinic I would guess had the SAMPLE drugs to prescribe to patients without health insurance to cover them ( freebies) --- I know when I moved out here and didn't have coverage the first visit they filled all my scripts without cost to me from their supplies.... when I needed refills I got the same companies pills ( now paying the bills with my coverage) I was amazed at how it worked out here...not the same back in Ontario thats for sure
Quick question... what's the COST to fill a script at a drugstore in the states? on average ( not cost of pills but fixed charge for the pharmacy )
Quote: coilmanwhile waiting at the clinic I go to out here in Western Canada the sales rep for a drug company came in to SEE THE DOCTOR.... his doctors like bag was as full as it could possibly be ... 15 minutes later when he left it was now empty. Clinic I would guess had the SAMPLE drugs to prescribe to patients without health insurance to cover them ( freebies) --- I know when I moved out here and didn't have coverage the first visit they filled all my scripts without cost to me from their supplies.... when I needed refills I got the same companies pills ( now paying the bills with my coverage) I was amazed at how it worked out here...not the same back in Ontario thats for sure
Quick question... what's the COST to fill a script at a drugstore in the states? on average ( not cost of pills but fixed charge for the pharmacy )
good question. That would depend. There are economies of scale where pharmacies that fill more rxs have less of a labor cost per rx.
But for the places I worked recently(busy)...the cost of labor only (pharmacist, technicians, cashier) was approx 5 dollars per rx in general. In my pharmacy its 4.80.
In a less busy pharmacy it can be 6 dollars.
Also as far as sales reps. If they were samples and not gifts(they can give cheap gifts like pads,pens, candy, desk clocks etc).....the samples may not always be to load up people who dont have insurance. Since sales reps are for brand name drugs which are usually very expensive....its better for the md to give a 7 day supply and tell the patient to try it and see if there is any good result or side effects....and then he would write an rx for 100 tablets. helps hold down costs. A full 30 day supply of some brand name drugs can be hundreds of dollars. No sense gambling that they get tossed.
Quote: LarrySgood question. That would depend. There are economies of scale where pharmacies that fill more rxs have less of a labor cost per rx.
But for the places I worked recently(busy)...the cost of labor only (pharmacist, technicians, cashier) was approx 5 dollars per rx in general. In my pharmacy its 4.80.
In a less busy pharmacy it can be 6 dollars.
.
Basically in Canada SHOPPERS DRUG MART rules the drugstore world... and well how about $12 a fill a script!!!
http://bc.ctvnews.ca/prescription-drug-prices-vary-drastically-among-pharmacies-1.1202330
Quote: AxiomOfChoiceThis has nothing to do with insurance. Even if I am paying out-of-pocket for my drugs, it's still illegal for a pharmacist to give me a different drug than the one that has been prescribed. Again, the doctor is the only one who is allowed to make that decision.
I just realized. There is no debate here. I am debating a person who is unarmed. Someone who has "opinions" and I live the FACTS.
20 years ago, for a side job I was hired for once a month visits to a local nursing home. My job was to review the charts and not just note drug interactions...but also review the diagnosis and labs and note any reccomendations at to the efficacy of the prescribed therapy.
I would then review my notes with the attending physician. They exisit today...consulting pharmacists. Yes we have an opinion and expertise on therapy efficacy.
Your claim that you would not ask a pharmacist about efficacy of a drug is based on ignorance, not facts. I would advise that you go on the web and view the activities of a pharmacist. We no longer hang out at a pharmacy, fill one or 2 rxs and make milk shakes the restof the day.
you seem to have changed your stance to...I would not ask a pharmacist about the efficacy of a drug...to pharmacists cant prescribe.
Even though pharmacists cant prescribe, doesnt mean their opinion on the efficacy of therapy isnt valued by educated people.
After a year of learning how to count to 100, and then the next year of learning how to pour from a big bottle into a smaller bottle, and then after 2 years of learning how to get that sticky label onto the the vial just right, and a year of drug interactions, I did get a few weeks on efficacy of therapy.
the funny thing is that I live a life where my opinion on efficacy is continualy valued....andI am actually arguing with some ill informed person as if he could possible have a leg to stand on.
5 years ago you would say....pharmacists cant give injections....if I need a flu shot, or pneumonia shot, or shingles shot, or tdap shot.....I will go to my doctor.They didnt learn that in school....they are just good for drug interactions.
the exchange is over......at least on this topic.....I am arguing reality and facts with someones uninformed "beliefs"...that is silly
Quote: coilmanBasically in Canada SHOPPERS DRUG MART rules the drugstore world... and well how about $12 a fill a script!!!
http://bc.ctvnews.ca/prescription-drug-prices-vary-drastically-among-pharmacies-1.1202330
what I QUOTED YOU WAS THE LABOR COST....you asked me the cost to fill a prescription.
when you take all the salaries of the daily staff and divide it into the number of rxs....thats the cost....so add 5 dollar to the cost of the drug....and thats the starting point.
there are no "dispensing fees" in most chains for cash customers. For example walmart charges 4 dollars for a month supply of some generics. Well if its costing them 5 dollars in labor, and the cost of the drug.....there is no "fee......
for cahs customers there is a selling price for each med calculated at the corporate office.
However for insurance copnmanies which is a large percent of business...there is a fromula for cost plus fee...and its nowhere near 12 dollars.
Quote: LarrySI just realized. There is no debate here. I am debating a person who is unarmed. Someone who has "opinions" and I live the FACTS.
You do this for a living and he's arguing with you. Amazing.
