If, and it’s a big if, I read this correctly. In 2009, Pfizer spent 2.9 billion in advertising (page 53) and 7.8 billion in research (page 46).
But, it’s 110 pages and I just searched for the words ‘research’ and ‘advertising’, so I may be wrong.
http://media.pfizer.com/files/annualreport/2009/financial/financial2009.pdf
And the amount of money they spend on advertising is blown out of the water by the amount of money they spend lobbying congress, the largest lobby in DC. In fact much of the restrictions on what drug reps are and aren’t allowed to do came about only recently, and restrict them from spending so much money bringing pens/paper/company sponsored stuff etc. http://www.postandcourier.com/news/2008/jul/13/drug_reps_face_new_restrictions_gifts_meals/
I definitely track that research costs are the big expense and why the drug companies hate generic drugs as they had to do all the research and have to recoup that expense. I think the advertising which is a bit on the dishonest side is advertising drugs to patients who factually have no training or clue at all as to why a certain drug should be prescribed. And I’ll bet there are dumb patients who come in and ask their doctor to give them the new “gee-whizbang-drug” they saw on TV while their doctor just rolls his eyes. I think if they are going to advertise, it should at least be to the people who can make rational choices about which drugs are correct for their patients.
I know that I have no training to make a decision on one prescription drug vs. another. That is why I go to a doctor for a prescription. When I didn’t understand something about the prescription, I deciced to ask here as it is a little tough to call the doctor on the weekend. And as I have had some actual medical professionals answer in the thread, I now understand what the prescription is.
But if I tried to make a choice based on the advertising I saw on TV, I think I’d be in big trouble.
Yeah, my department doesn’t get a whole lot of samples these days. We’ll sometimes get them for really low-end stuff like vitamins or soothing eye drops (ophthalmology), but not much else.
At my med school/hospital, we’re not allowed to have any pharma presence anywhere. It’s a relatively new rule, and all the students moan about not getting our free lunches anymore, but it’s not too big a deal for us. At one of the private hospitals in the area I was rotating through, I did get free lunches, but it always felt a little ethically questionable. The best way to get around it I found was to show up too late to hear the rep talk, but still get the food.
We rarely prescribe Vicodin (instead using Norco) because the risk of abuse of the narcotic increases the risk of tylenol overdose.
Which is funny, since part of the reason Tylenol was added was to discourage abuse. The idea was that a Tylenol overdose would be too unpleasant.
Also, I’ve read that there’s a pretty reliable method of removing the Tylenol from those meds.
Wow, that is really interesting. Never would have thought that at all. Since I don’t plan on abusing it, I guess I don’t have too much to worry about either way. But it is starting to make more sense why you might say Norco instead of Vicodin. Both have the same ingredients, but the dosages differ.
Damn, I alaways learn new stuff around here! 
In my experience, the people who are abusing narcotics don’t care about the tylenol.
At my hospital, I have basically stopped giving Lortab (the oral painkiller of choice going back to when I started nursing school) and started giving Norco within the last year or so. The reason is because of the acetaminophen content, as it’s lower in Norco (as already mentioned) and apparently some people are getting antsy about it. Our pharmacy’s default is to now switch Lortab orders to Norco unless specifically instructed not to.
Well, with my benzo addiction (despite taking the medicine only as prescribed), while looking for support, I stumbled on a few websites devoted to all illegal drugs, and the way to remove the Tylenol was a sticky.
But I agree that most people don’t notice the Tylenol overdose symptoms. But I did read that, while the main focus was to add to the pain relieving properties, Tylenol was also supposed to discourage overdose. It just didn’t’ work.
Vicodin comes in 5/325 or 5/500.
Norco is 10/325 (or maybe 10/500- I don’t recall)- good for reducing the amount of acetomenophen one consumes in a day. It is recommended to keep acetomenophen down to 2000 mg or less in a 24 hour period.
Vicodin comes 5/500, 7.5/750 (Vicodin ES), and 10/660 (Vicodin HP).
Norco comes 5/325, 7.5/325 and 10/325.
Lortab comes 5/500, 7.5/500, and 10/500.
Lorcet comes 10/650 and 7.5/650 (Lorcet Plus).
Lortab Elixir comes 7.5/500 per 15 mL.
Vicodin has variable amounts of acetaminophen. Norco is always 325mg, Lortab is always 500mg, and Lorcet is always 650mg.
I’m sort of confused as to why this was posted, because all of it is wrong. We’ve already been through the difference between norco and vicodin and the APAP dosing variations, and the limit on APAP consumption /24hr is 4 grams, not 2g.
Sorry- I missed your previous post, but it’s not wrong. Bambi has the most complete and accurate information.
Also, I understand 4 grams is the max, but 2 grams is the recommendation.
5/325 is not called Vicodin, it is called Norco. There is no 325 strength of vicodin out there. That’s the whole point of this discussion, not all hydrocodone/apap variations are called Vicodin even though they are by the public. There is a difference, esp to those of us working in pharmacy.
Yeah, a lot of our consultants order vicodin 2 tabs every 4 hours as needed for pain; I have to rewrite the orders because they’ll end up taking too much acetaminophen if they take 1 gram of it 6 times a day.
If the patient needs oxycodone, I just order the version without acetaminophen in it so I don’t have to worry about its toxicity. But you can’t get hydrocodone without acetaminophen in the US.
What exactly does a Tylenol overdose entail?
APAP is metabolized in the liver, so toxicity causes liver failure.
I <3 my doc, he has it all computerized, so I get a great little typed out in proper format scrip generated by the computer that he then signs and stamps with his registration number. Impossible to misread 
The paper he has has the traditional no erase paper up in one corner and then under it is a short paragraph on specifically how he wants me to take it [or I suppose any comment that the office were to type in, like a recipe for cranberry sauce or whatever.
I know that the pharmacy has a handout with all the information that would be on the in box handout, but I like having a short recap of how he wants me to specifically take it, because we discuss how stuff will fit into my normal medication routine which may be different than the generic 3x day - I might have specific times listed.