18 Comments

Hello, fellow musical theatre nerd! I knew you were a kindred spirit 😂

“This is why many drugs that are known to be safe in pregnancy and breastfeeding still have the product information cautioning against their use. It’s a real problem in clinical practice, and a cause of a lot of confusion. Again, another potential for further rich discussion that I’ve got to resist…for now.”

I *really* look forward to reading a post about drugs in pregnancy and breastfeeding at some point! It was a huge source of anxiety and confusion for me with my pregnancies and breastfeeding years for both my kids. You are so good at explaining everything to an audience of non-experts, so I know I’ll find it super enlightening!

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Kindred spirit indeed!

I’ll definitely work on something regarding pregnancy and breastfeeding. I spent some formative professional years in a women’s and children’s hospital on the drug information phone line so it’s something near to my heart.

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OK, you won't lose me as a subscriber for being into musical theatre (as I was as a teen), but dissing the Sound of Music? I dunno, man...remember the optimal drug advice of "set and setting"...meaning, have you ever attended a movie theatre sing-a-long of SoM? If not, it's a singular high lol.

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😂 Now that I’ve learned about collective effervescence I have a new openness to a sing-a-long screening!

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Haha brilliant!

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Love this , you explain it so well for the lay person. I also love Calamity Jane, I still sing out loud ‘just blew in from the windy city’ 😂 Grease, you didn’t mention seven brides for seven brothers ? Love the photos at the end 😁

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Ah, a fellow Calamity Jane lover! Thanks Francis!

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Once again, I work in this industry, and the way you’ve described this is exposing things that I didn’t even know I didn’t know. Also, the Sound of Music is such a staple in my family (and I do also love Radiohead and Batman). Can we pretend like you wrote this just for me?

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PS you just snuck cast photo at the end of this post, but I think it might be the best part.

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Aww, I’m so glad you liked it! And thanks for noticing the photo- it felt wrong not including one, but I was too shy to put it in a prominent spot 😂

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"Anything outside of that is considered ‘off-label’. This doesn’t make it inherently bad, it just means there’s a bit more work involved."

Yeah, I think OL prescribing is inherently bad. I consider it malpractice. It's an arrogant doctor believing THEIR individual judgment is superior to the entire science evidence-based enterprise. Bad medicine.

BTW: your writing could be a casebook for how to engage and entertain readers while simultaneously educating them about important stuff. Great writing Lauren!! 👏👏

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I completely agree that there are circumstances (probably many) where it is an expression of arrogance rather than pragmatism. I must’ve been having a less cynical moment 😂 .

That being said, Ive also practiced mainly in paediatrics and palliative care, where they wouldn’t get by without off label prescribing. Especially in Australia where we have a lower number of liquid products available. So I do think there’s a place for it- but I am concerned it’s becoming too much of a regular thing that people don’t even think about.

Thanks so much for reading, and for the encouragement regarding the writing Baird- you don’t know how much I appreciate that.

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Thanks for the nuance on the OL issue Lauren. I get your drift. I just worry about the majority of doctors who think they're scientists without even knowing what "science" is. I write a lot about that issue.

Always nice to recognize good writers. They're such a treat amidst all the garbage floating around the interwebs!

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I very much share your concerns. Consider these posts as laying some of the groundwork for the posts to come 😊

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THE HILLS ARE ALIVE WITH THE SOUND OF US COLLABORATING ON A POST SOMETIMEEEEEE

You know it's true!

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Mate, I think you’re over estimating my ability to have a post prepared ahead of time 😂

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It’s worth noting that it’s a business decision, not a scientific one, whether to spend the vast amounts of money needed to get a new indication for a prescription drug. If the drug g he as been around for a while or the condition is uncommon, it is unlikely that will ever happen.

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Yes, return on investment is what all these decisions are based on for drug companies- agreed.

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