Faculty Bibliography

Forced substitution is a growing practice that occurs when an insurance carrier tells its patients that it will only cover certain drugs in a class, but not others. This practice may or may not be good business, but it is definitely not good medicine. Drugs are not identical. Rather than saving healthcare dollars, ironically, forced substitution may end up costing more in the long run -- one must factor in the cost of unnecessary side effects or of a preventable illness like heart disease

The reality: A complete cure for metastatic (stage 4) breast cancer is unusual, but the five-year survival rate with appropriate treatment (surgery, radiation, chemotherapy or a combination) is 20%, according to the American Cancer Society.

Private Practice [Television Program] -- According to [Michel Dubois], since the patient is undergoing surgery while suffering from congestive heart failure, 'the need to maintain an airway and ensure adequate respiration no matter what kind of anesthesia is used is crucial.' But the clinic doesn't appear to be outfitted with breathing tubes or respirators, so epidural anesthesia would have been Addison's best and safest choice, though still quite risky. As the patient becomes more lethargic, [Pete Wilder] implores Addison to perform an emergency caesarean section. Addison hesitates because the clinic doesn't have general anesthesia, blood for transfusions or sterile drapes. It also doesn't have the ability to treat the patient's pain properly because, Addison says, epidural anesthesia wouldn't act quickly enough. Still, Addison and Pete conclude that they don't have 'the 10 or 20 minutes' it would take for an ambulance to arrive. Concerned that the patient will 'feel every slice,' Pete offers an alternative treatment to traditional anesthesia -- using needles, combined with injected Lidocaine, to block pain receptors in the body

The author never believed it was entirely fair that Eli Lilly was the target of vicious attacks regarding its anti-psychotic drug, Zyprexa. For one thing, many psychiatrists found, and still find, it to be effective. He was concerned that the fallout would stymie Lilly and keep it from innovation. So it is with much applause that he noticed the early success in trials of its new class of anti-psychotic drugs. Whether of not the new drug, LY2140023, becomes the next great anti-psychotic drug in clinical practice, Lilly deserves to be congratulated for developing it

Brave One [Motion Picture] -- As her body heals, she remains more sensitive to light and sounds and no longer feels safe. Back on the radio, [Erica Bain] comments that she has turned into 'a restless stranger who keeps walking, eating, living.' Aside from these feelings of depersonalization, she is riddled with anxiety and fear, and she survives by taking Valium, smoking cigarettes -- and creating a new identity as a vigilante. [Jodie Foster]'s portrayal of a severe untreated case of post-traumatic stress disorder is striking but obviously quite exaggerated. 'She didn't get the help she needed,' the actress has said of her character, as an explanation for why she snapped. Although aggression and even violence can be the result of untreated PTSD, a complete transformation to killer vigilante is very difficult to believe. 'Post-traumatic stress,' she says, 'is a mismatch between what we think the world should be like and what it is really like. We aren't prepared.'

Death at a Funeral [Motion Picture] -- The reality: Despite being a farce, 'Death at a Funeral' accurately portrays many of the medical realities of mixed hallucinogens, and the onset of the drugs' effects could well be within several minutes. Hallucinations distort shapes, movements and the passage of time. 'Good trips' may include euphoria and heightened understanding; 'bad trips' may involve terror and despair. LSD, which typically lasts for eight hours, alters perception and cognition while causing wild emotional shifts and intensifying the senses. Ketamine (a PCP-like drug known in recreational drug circles as 'Special K') lasts at most a few hours. That drug, an anesthetic (numbing) agent, leaves users semiconscious. 'They lose their coordination while at the same time feeling they are stronger and impervious to pain,' says Jim Adams, an associate professor of molecular pharmacology and toxicology at USC. This paradox is the reason ketamine users often die from drowning, Adams says, and it may explain why [Simon] believes he can climb around the roof so easily. One rationale for mixing in mescaline, a much less potent hallucinogen than LSD, is that it tends to make the hallucinations last several hours longer, Adams says. This appears to be the case for Simon, who shows no signs of improvement over the course of the film

Last fall, the Centers for Disease Control vaccine advisory panel voted to make the shingles vaccination routine for the 50 million Americans over the age of 60. As a practitioner, the author is traditionally slow to change, and he tends to be a cautious observer in the first year of a new drug or vaccine's existence, but now that Merck's safe Zostavax has been available for more than a year, he has begun to eagerly order his supply. The vaccine not only prevents shingles, it also reduces the excruciating post herpetic neuralgia by more than 65%