[Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

[Tannert,Karen (DSHS)]

Even when I was in pharmacy school in the 80's we discussed the shotgun approach to dosing.  The developers seek an average that will correctly treat the most people without killing them - bell curve. Consider that the first stage of human testing is usually healthy males around 25 years of age. Individualized dosing based on genetics, metabolism, etc. was pretty much a pipe-dream at that point, but I've seen research creeping in that direction.   An example, when I first started practicing was low dose estrogen birth control pills. They just started appearing on the market in the 80's when it was shown that the existing estrogen/progesterone combo products were overkill.   I think  drug companies should continue to tweak their products as they see what works at the most efficient dose possible, but I doubt they will without legislature/FDA/public hanging over them.

Karen Tannert, R.Ph., M.P.H.
Drugs and Medical Devices Group (MC 1987)
Texas Department of State Health Services
P O Box 149347
Austin, TX  78714-9347
(512) 834-6755  ext. 2350
(512) 834-6759 (fax)

From: Gilliam, Allen [mailto:GILLIAM at adeq.state.ar.us]
Sent: Wednesday, January 07, 2015 10:08 AM
To: Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste at lists.dep.state.fl.us
Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

Thanks for the reminder and edification to all that responded.  Laurie said it in the most simplest terms this mechanical engineer could understand, “That’s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.”

I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment.  Jim’s chart was quite surprising.  Don’t think I’ve seen anything like it before.

Jim?  What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy “leftovers”?

Allen Gilliam
(Pharmwaste not in my job description, just continually passing thru)
ADEQ State Pretreatment Coordinator
501.682.0625

From: Heil, Ann [mailto:AHeil at lacsd.org]
Sent: Wednesday, January 07, 2015 9:34 AM
To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

Just to chime in here, just because a pharmaceutical passes through your body doesn’t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst – it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them.

Ann Heil
LACSD

From: pharmwaste-bounces at lists.dep.state.fl.us<mailto:pharmwaste-bounces at lists.dep.state.fl.us> [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Catherine Zimmer
Sent: Wednesday, January 07, 2015 7:09 AM
To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

Hi Allen and all,

Yes, if you remember some years back, Ann Heil from I think its LA’s wastewater district compiled a list of metabolism vs. pass through of a number of common rx.  And a EPA, Region 3 scientist says, I paraphrase here, “the drug companies overdose us”.  Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so.  Now, maybe with Almeda Co.’s take back ordinance, or maybe if EPA demanded Pharma clean up the nation’s waters—that would be incentive to develop more site specific and directed drugs.

Following up on Jim’s comments—I have done exactly that with my physician. When she prescribes a drug—for which there is no rx-free alternative treatment, we’ll get out the package insert to identify the amount that passes through.  A good education for both you and your MD.

Very truly yours,

Catherine Zimmer, MS, BSMT
Zimmer Environmental Improvement, LLC
St. Paul, MN
Ph:  651.645.7509
zenllc at usfamily.net<mailto:zenllc at usfamily.net>

From: pharmwaste-bounces at lists.dep.state.fl.us<mailto:pharmwaste-bounces at lists.dep.state.fl.us> [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Gilliam, Allen
Sent: Wednesday, January 07, 2015 8:39 AM
To: jmullowney; Bill Speenburgh; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

So the general public would not realize they’re paying for perhaps 25% of the (almost prohibitively) expensive drug they’ve been prescribed; the rest being wasted to the environment?  Sumpthin just doesn’t pass the smell test on this scenario.

Allen g

From: pharmwaste-bounces at lists.dep.state.fl.us<mailto:pharmwaste-bounces at lists.dep.state.fl.us> [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of jmullowney
Sent: Wednesday, January 07, 2015 5:38 AM
To: Bill Speenburgh; pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

Bill
You do not need to have your urine tested you can just read the drug insert,that pice  of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA.
A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects.
Not all drugs are hazardous to  humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs.
Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org<http://www.cytotoxicsafety.org>


Sent from my T-Mobile 4G LTE Device

-------- Original message --------
From: Bill Speenburgh <wcermail at gmail.com<mailto:wcermail at gmail.com>>
Date:01/06/2015 8:15 PM (GMT-05:00)
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Cc:
Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1

As a  person with Type II diabetes, I am prescribed by the VA with 2 x 1000
mg tablets of Metformin per day.  Maybe I will get my urine tested to see
what passes thru?

William G. Speenburgh
World Class Environmental Resources, LLC

(973) 770-2275 (Phone)
(973) 219-5720 (cell)

-----Original Message-----
From: pharmwaste-bounces at lists.dep.state.fl.us<mailto:pharmwaste-bounces at lists.dep.state.fl.us>
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of
pharmwaste-request at lists.dep.state.fl.us<mailto:pharmwaste-request at lists.dep.state.fl.us>
Sent: Tuesday, January 6, 2015 3:54 AM
To: pharmwaste at lists.dep.state.fl.us<mailto:pharmwaste at lists.dep.state.fl.us>
Subject: Pharmwaste Digest, Vol 111, Issue 1

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