Pharma marketing tips

Medico marketing tips

1) selling of the pharma drugs is possible with
 

    Knowledge

2) Scientific reports

3)  It is a  job of good product manager to gather not only


   Recent information about the drug or disease but all generations of the drug
 


   4) History makes the detailing story interesting  and one way could compete the compitator.


    5)  Recent knowledge before it is circulated in the field  is always welcome



       By the doctors

6) In my personal experience  while introducing a new product doctor instructed to hospital staff although doctor was going for emergency operation  please ask me to wait

Docttor ask me  to share all information 20 valuable minutes we're spent by doctor
7) So never think doctor is not allowing time to discuss important features
8) You should read the face of doctor when he is not interested take it as order do not keep on detailing like a Pooja you may say  good  day.

9) spending time with doctor will give a better business .
 

Heart Disease 2

                                Heart Disease 2

Dr Roshman and Dr Friedman  in 1950 discovered Type APersonality in heart disease 

Patients with impaired coronary circulation.Researcher were
helped by a  person whose job was to repair sofas .Once the gentalman notice in above doctor's clinic that every time unlike my other customers here the sofa requires front side stiching .He reported his clever observation to these doctors.

Dr gave a thought over it and notice that his patient are impatient and anxious so that they sit much forward part and the frequent sticking required
 They called a Type A personality .

Characteristics of Type A personality

1) competitive
2) constantly watching watch

3)Impatient

4)Do not have time for family.

Heart disease 1

                                    Heart Disease 1

During first world war Europeans had to face scarcity of food.Europiens then deprived for mutton eggs milk cheese for long time even during  post war peroid .

Post war food for Europeans , potato vegetables and legumes .


Doctor's from Finland Dr Emari and Dr Kanelha observed the number of deaths due to heart diseases significantly lowered on post war perood compare to pre war peroid.

The above Finland study disproved the theory that for heart disease the sole cause is       heriditary.

      For maintaining proper metabolic  functions of the heart balanced diet

         is requried .Simlarly stress free life is essential for normal heart functions.

        Stress was common to even our ancestors living in cave.
     
          Wild animals were constant threat to humans life in cave  .


           For running away from wild animals tiger lion one must have strong leg muscles

Required for running .Heart must supply proper blood supply .
 




         Today we have different causes for stress .we should have matching dress while going to office we should try to reach on time to office mere thought that today boss will ask if we have complited the yesterday's task will trigger our stress levels.insulting of boss in front of office staff adds to stress some times our ancestors life was better than today's boss cabin as we cannot run away from boss cabin when boss is scolding.

Economical stress adds up this finally increases  stress harmones unlike in past where our ancestors used to utilised the stress hormones by running away from threat of wild animals we give stress to heart as we cannot run away from daily stresful events.This results in hypertension heart disease.




       Astronuts blood pressure before entering space is unstable but once he reaches in space his blood pressure stabilizes


    This skill of astronuts should be implemented in day to day practice to have some control on BP.
Scientist from America carry out study  on monkeyes .There we're two groups A and B group A monkeys were kept in group in single cage . Group B monkeys were kept in isolation experiment was for 21months.All monkeys food was same.
Observation group B monkeys showed blokages in blood vessels and Group A monkeys free  from blokages .conclusion isolation increases stress and blokages on blood vessels.


 

Tumour Markers

                         Tumour Markers 

Cancer is an abnormal growth that originates within human body and  although there are

different types of cancer but  all share hallmark of characteristic that unchecked growth 

Progress to a limitless expansion.

 Cancer grows and expands and spreads by metastasis ie some cells detached from primary tumour spreads into the even at times distant organs and establishess secondaries .
Tumor Markers required to understands the growth as we use to record the fever  using thermometer , blood sugar to monitor diabetes


Ideal tumour marker :
Be specific for the tumour
Level should change in response to tumour size

An abnormal level in response to micro metastasis
 Both sensitivity and specificity required

It should help in diagnosis and prognosis



So we can say an ideal tumour marker should be specific and sensitive.

Sensitive tumour marker value should increase even if micrometastasis grows

1) CEA : tumour marker called carcino embryonic antigent

        Cancer is back ward process so cea increases in cancer

      This test is non specific and non sensitive

Abnormal readings are seen in smokers cirrhosis

Ulcerative colitis hence first diagnosis is required and then Monitoring possible   for breast cancer pulmonary cancer and  colorectal cancer

 2)      CA--125  notice in 50percent early overian patients
   
             CA-125  increases in appendicitis, pregnancy and ovarian cyst

           The CA-125  lacks sensitivity and specificity.
            This test is useful in monitoring ovarian cancer recurrence
               and treatment .




 3)
      Ca15--3 :Not specific or sensitive enough to detect early breast cancer .


         Low value of CA15 --3 did not rule a carcinoma,an elevated value ,greAter than 35
   
       Units /ml suggested malignancy .


As a rule CA-15 should be used after the diagnosis of breast cancer .

CA15-3 elevation may be due to ling ovarian liver and colorectal
Cancer.


      4) PSA (Prostate SPECIFIC  ANTIGEN :

            Elevated in high Prostate cancer ,in benign prostate ,hypertrophy and

          Prostatits
Monitor recurrence and response to treatment




       
   

Human Genome ---Pharmacogenomics

Human Body is compsed of 100 Trillion cells .The number of cells if compaired to number of brics required for a 150 storied tower the number is negligible to 100 Trillion .
 One Trillion means 10000000000000 from this number we get an idea of complexity of body functioning.

   Every cell is having at it's centre nucleus .

If nucleus is alive then cell is alive .Nucleus is like central government .Inside nucleus there are chromosomes these chrosomes are colourless . 

Flaming Scientist stained chromosomes in 1880.

Chromosomes are sites for chain of genes . 

What is DNA ?

  Every body knows because of TV serial like 

  CID .

   True parents could be identified by DNA 

    Study.

    DNA carries heriditary traits .Parents give us set of chromosomes 

   Human chromosome number is even as each parent contributes one set of chromosome

Mother contributes 23 chromosomes 

And father contributes 23 chromosomes so that each human  cell contents 46 chromosomes.

First 22 pair of chrmosomes do not contribute sex 

Last 23rd pair contains sex chromosome

if  XX means female and X Y means male .

DNA carries thread of Gene .DNA structure  is like spiral staircase


      Each stem of step isade up of two letters either A with T or C with G


        What is A it's an adenine T is  Thyamine  A is always associated  with T .


         G means Guanine and  C means Cytosine ,remember G always associated with C

          DNA code language message passes via these four letters ATGC



               How many genes are there in a human body ?
 

 The total number of genes present or located on 46 chromosomes

Genomic project started in 1989 and completed in 2003

The cost of genomic project was huge 6400million dollars spent .1000 scientist worked.

Genomic discovery resulted in finding out toatal 30000 genes in entire human genes.

Total 6400 millions pair bases AT and CG were recorded in entire human genome .

Surprisingly  99.7 %of pair bases we're alike to any person in the world .It means only

0.30% pair bases are different  which is contributing difference of color height and many

Differences among us

What is pharmaco genomics ? The study of genomic response to each drug .Although the drug is same the disease is same indication is same standard dose is used is also correct

Results may vary from good or the drug may not work

Or drug may be toxic .why this happens ? It is because of alter pharmacodynamics due



 To individual genomic contributed by parents

Let us know what is the jorney of the drug in our body

1) entry


  2)The drug travels in our body through a check post imp


    Liver here the drug interacts with  specific enzymes from P450 a cluster of enzymes

    These enzymes changed according to genomic set up

   Some enzymes due to mutational changes in genomic set up either do not work or may produce toxic by products.This alteration occurs due to non performing or harmful effect of Gene


      3) after metabolism as discussed above goes on to next step


     4)Drug waste is excreated



        Pharmacogenomics : Clopidogrel ,this drug   avoids platelets aggregation

 
          . Cyp2c19 is cytochrome enzyme requried for the metabolism of Clopidogrel


           If cyp2c19 cytochrome enzyme is altered due to genomic changes in patient


 The desired effect is not achieved or mild effect or toxic effect  may be achieved due to genetic mutation by genome


     To know that drug will not show desired effect specific genomic test should be carried out   which will cost 1000 us dollars.


Such testing is ideal for anti cancer drugs where the toxicity profile is high and patient need .



Not suffer

           

Heartburn

You have just eaten a big meal and lean back in your favorite chair. Then  it  happens  , your chest starts to hurt so much it feels like it is on fire.

Every day as many as 10% of adults have heartburn which produces a burning sensation of food re-entering your mouth
,(regurgitation) .
It results from gastro esophageal reflux a condition in which stomach acid or bile salts back up into food pipe (oesophagus).

  When there is also evidence of esophageal  irritation or inflammation . You have gastro esophageal  reflux disease (GORD)

        Heartburn is one of the most common

Condition affecting the gastrointestinal system .

7% have daily heartburn
15-50% have monthly heartburn .

Heart burn causes :when you swallow the lower esophageal sphincter a circular band of muscle around the bottom part of your food pipe relaxes to allow food and liquid
To flow down into your stomach .
But when it relaxes at the wrong time stomach acid flows backward up into your food pipe ,even you are in upright position.

Factors responsible

1). Fatty foods
2)chocolate
3) caffeine
4) onions
5) spicy food
6) large meals
7)lying down soon after eating

Symptoms
GERD. Gastro esophageal reflux disorder

1)Heartburn Burning or tightness behind the breast bone

2) Acid regurgitation: Sour or bitter taste
     In the throat or mouth

3) Water Trash : a hot sensation in the stomach followed by large amount of watery liquid in the mouth

4)   chronic cough can be caused by GERD

Non prescription Therapy

1) Avoiding foods that induce reflux fat coffee etc
2) Avoid eating closed to bed tim
 

3) Elimination of smoking

4) Elimination of alcohol
5) weight loss

6) Elevation of the head of the bed

Remember  follow only doctor's advice

Know your cholesterol

   Cholesterol
1) Soft fat like waxy substance

2) Found in blood ;cells and food we eat

3) Needed for cell membranes

4) Helps in making hormones and  Vitamin D

5) Cholesterol is manufactured I'm the liver

6) Cholesterol sources meat poultry fish eggs butter

     Whole milk cheese .No plant sources

                      Good Cholesterol (HDL)

    Tends to carry cholesterol away from arteries and back
 
     and back to liver where it is broken and excreated

                            Bad Cholesterol (LDL)

Too much can clog arteries .
LDL bad cholesterol has tendency to built up on walls of arteries
Bad cholesterol is harmful can cause heart attack
Brain attacks also called as stroke.


                    Saturated  Fats
   
          Fats are fattening

         Eat Fats less than 30 percentage
         Of daily calories


    Saturated Fats 10%
         Unsaturated Fats 20%


Cholesterol Ratio

Total Cholesterol/ HDL cholesterol

Normal  less than 4.5

Eg  if Total Cholesterol 200
And HDL cholesterol 50
The ratio 4

If Total cholesterol 200
And HDL  cholesterol 30
Ratio 6.6
Although Total cholesterol is same since HDL Cholesterol  is different.


   
 Total cholesterol:. Optimally less than 200 mg% .

Borderline high 200-239mg%


High risk 240mg% and above

Bad Cholesterol (LDL) : optimal less than 100mg%
Border line high 130--- 159mg%

High Risk

160mg,%and above

Good cholesterol (HDL)    optimal
Less than 40mg% for males
And less than 50 mg% for females

Ref National. Cholesterol education

Cholesterol 1000mg produced daily in our body
From our daily diet we get 300 mg cholesterol
Cholesterol / 100gm of chicken 78mg
Chicken liver contains 472mg cholesterol per 100gm

Yellow part of egg contains 260mg cholesterol per egg
Prawns per 100gm cholesterol
Quantity is 150mg
White of an egg is cholesterol free.