The Ingredients: Triflupromazine Hydrochloride
Dosage Form and Administration: Tablet; Oral
Drug Trade Name: Vesprin
Firm: Bristol Myers Squibb
Strength: 10MG
New Drug Application Type: N
The Drug Application Number: 11123
Medicine Product Number: 1
Approval Date: 1/1/1982
Reference Listed Drug: No
Type: DISCN
Applicant Full Name: Bristol Myers Squibb Co
Local Number: 35570

Overloaded Physicians

All of the professionals in our healthcare system struggle under the crushing weight of cost control measures imposed by insurers and medical institutions, which force doctors to minimize the time they spend assessing, treating, and discussing options with patients and their families. Protecting a family in an overtaxed healthcare system requires expertise. The statistics on medical errors, while often quoted, are still disturbing. In the United States, over 70,000 people die every year because of preventable medical errors that occur in hospitals. That means these avoidable mistakes kill more people than breast cancer or traffic accidents, making medical errors the eighth leading cause of death in the country. The report found that these errors were not the result of individual recklessness on the part of caregivers, but basic flaws in the organization of the American healthcare system. The treatment of over 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression, and other chronic illness is inadequate. Due to cost constraints and resource limitations, doctors are not able to spend adequate time with their patients and do not necessarily have access to information on all available forms of treatment. In addition, when patients see more than one doctor, their care, medical records, and medications are rarely effectively coordinated. The burden of managing treatment most often falls on the shoulders of the patient and family who are already overwhelmed by having to deal with a serious illness. The average office visit is 10 minutes and physicians may be seeing as many as 40 patients a day. In addition, there are long waits for rushed appointments, the confusion about what types of care are available and best suit the needs, and the stress of navigating the U.S. healthcare system. When dealing with a serious medical situation, it is only natural to be overwhelmed. People tend to be confused about their options and too distracted or upset to ask the important questions. IPA Health provides private health management services.

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Isotretinoin

A daily oral intake of vitamin A derivative isotretinoin (marketed as Accutane, Amnesteem, Sotret, Claravis, Clarus) over a period of four to six months can cause long-term resolution or reduction of acne. Doctors believe that isotretinoin works primarily by reducing the secretion of oils from the glands, however some studies suggest that it affects other acne-related factors as well. Isotretinoin research shows it to be very effective in treating severe acne and can either improve or clear well over 80 percent of patients. The drug has a much longer effect than anti-bacterial treatments and will often cure acne for good. The treatment requires close medical supervision by a dermatologist because the drug has many known side effects (many of which can be severe). About 25 percent of patients may relapse after one treatment. In those cases, patients require a second treatment for another four to six months to obtain desired results. Doctors recommend that one allow a few months pass between the two treatments, because acne can actually improve somewhat over time. Occasionally a third or even a fourth course is used, but the benefits are often less substantial. The most common side effects are dry skin and occasional nosebleeds (secondary to dry nasal mucosa). Oral retinoids also often cause an initial flare up of acne within a month or so, which can be severe. There are reports that the drug has damaged the liver of patients. For this reason, doctors recommend that patients have blood samples taken and examined before and during treatment. In some cases, doctors terminate or reduce treatment due to elevated liver enzymes in the blood of the patient, which suggest a link to liver damage. Other dermatologists claim that the reports of permanent damage to the liver are unsubstantiated, and deem routine testing unnecessary. A doctor must also monitor the blood triglycerides. However, routine testing is part of the official guidelines for the use of the drug in many countries. Some press reports suggest that isotretinoin may cause depression but as of September 2005, there is no agreement in the medical literature as to this risk. The drug also causes birth defects if a woman becomes pregnant while taking it or takes it while pregnant. For this reason, female patients are required to use two separate forms of birth control or vow abstinence while on the drug. Many doctors only supply isotretinoin to women as a last resort after milder treatments have proven insufficient. The USA put into effect restrictive usage rules (see iPledge program) beginning in March 2006 to prevent misuse, causing occasioned widespread editorial comment.