Pfizer developed and marketed the drug Viagra to treat erectile dysfunction. However, some deaths were linked to Viagra due to heart attacks or strokes. While the FDA considered the drug safe, there is debate around Pfizer's ethical responsibilities in thoroughly researching risks and ensuring consumer safety. Recommendations include Pfizer conducting more rigorous clinical trials, improving warnings to doctors, and considering whether marketing a drug primarily for enhanced sexual performance is ethical if life-threatening side effects are possible.
Dealing with Substance Abuse in the WorkplaceCase IQ
Security expert Timothy Dimoff discusses tips for dealing with substance abuse in the workplace. To view the webinar recording, visit: http://i-sight.com/webinar-substance-abuse-in-the-workplace/
Vf Presentation Herbst Campbell May 2008Teresa Hall
If you want to share a great concept, get healthier and wealthier, check out the 15 minute short presentation.
email me if you want more info.
communiationandmore@yahoo.com
Teresa
Dealing with Substance Abuse in the WorkplaceCase IQ
Security expert Timothy Dimoff discusses tips for dealing with substance abuse in the workplace. To view the webinar recording, visit: http://i-sight.com/webinar-substance-abuse-in-the-workplace/
Vf Presentation Herbst Campbell May 2008Teresa Hall
If you want to share a great concept, get healthier and wealthier, check out the 15 minute short presentation.
email me if you want more info.
communiationandmore@yahoo.com
Teresa
Viagra Promotion Strategy Mod 23rd April 09Siddharth Soni
Got an opportunity some time back to present a promotion strategy for the wonder drug VIAGRA in India. So here's what I presented.
Did it get implemented? No! I heard that Pfizer works like a bureaucracy... Can't say anything about the veracity of the claim but if it's true, by any chance, then they need to pop the same drug that they prescribe :).
Healthcare providers are increasingly breaking the secure supply chain and endangering patients. Learn about counterfeit drugs and most recent incidents involving providers.
Also learn about how you can be a part of the solution by working with the Partnership for Safe Medicines.
This SlideShare gives an overview on how a drug is discovered, researched, developed, tested and reviewed for approval. It follows the current standard of approval set by the Food and Drug Administration (FDA), a federal agency of the United States Department of Health and Human Services. The process is generally divided into 4 Stages: Pre-Clinical, Clinical, New Drug Application (NDA) Review & Post-Marketing.
Special Challenges in Clinical Trials: Case Study: the Dying child and the ...Michael Swit
A review of a case study involving whether it would be proper to authorize the use of a drug whose approval had been withdrawn when it is believed to be the only hope for a dying child.
Viagra Promotion Strategy Mod 23rd April 09Siddharth Soni
Got an opportunity some time back to present a promotion strategy for the wonder drug VIAGRA in India. So here's what I presented.
Did it get implemented? No! I heard that Pfizer works like a bureaucracy... Can't say anything about the veracity of the claim but if it's true, by any chance, then they need to pop the same drug that they prescribe :).
Healthcare providers are increasingly breaking the secure supply chain and endangering patients. Learn about counterfeit drugs and most recent incidents involving providers.
Also learn about how you can be a part of the solution by working with the Partnership for Safe Medicines.
This SlideShare gives an overview on how a drug is discovered, researched, developed, tested and reviewed for approval. It follows the current standard of approval set by the Food and Drug Administration (FDA), a federal agency of the United States Department of Health and Human Services. The process is generally divided into 4 Stages: Pre-Clinical, Clinical, New Drug Application (NDA) Review & Post-Marketing.
Special Challenges in Clinical Trials: Case Study: the Dying child and the ...Michael Swit
A review of a case study involving whether it would be proper to authorize the use of a drug whose approval had been withdrawn when it is believed to be the only hope for a dying child.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
7. Ethical Responsibilities of Drug
Manufacturers
£ Duty of care to the health & safety of all
£ Disclosure of risk involved
£ Dealing with this risk best
£ Thorough research of the drug & its effects on all
stakeholders
£ Organizational ethics
8. Ensuring Product Safety
£ Assumptions made:
£ Legally approved by FDA
£ Consumers’ responsibility
Pfizer’s responsibility:
£ Manufacture products that meet safety standards
£ To minimize the risks and ensure the utmost safety of
consumers
10. What has Pfizer done?
£ Clinical trials:
£ 21 randomized trials that
took place over 6 months
£ Tested on > 3,000 patients
aged 19-87
£ Was this enough?
£ Inherent limitations of pre-
testing
11. What has Pfizer done?
“It is not possible to determine whether such cases –
the reported deaths and other serious consequences-
are directly linked to Viagra”
Pfizer
12. How Safe is Safe?
£ Concept of acceptable risk
£ Consider sufferers
£ Is it based on personal
judgment?
£ Difference between accepted &
expected ethical standards in
society
14. Product Labeling
£ Why is it so important?
£ It is the most basic and
direct method a company
uses to communicate
information about its
product to its consumers
15. Product Labeling
£ Label updated within 8 months of its approval in 1998
£ Updated again in 2005 and in 2007 to include potential
visual & aural loss
18. Instructions to Physicians
Why is it so important?
Viagra is only available through prescription.
“And there's only one way to get one. Talk to your
doctor. He can prescribe VIAGRA if he thinks it's
right for you.”
Viagra.com
19. Instructions to Physicians
Efforts by Pfizer:
“In May 1998, Pfizer issued a "Dear Doctor" letter
warning of the large and sudden drops in systemic
blood pressure occurring in the majority of patients
taking Viagra®. Doctors were advised to consider the
cardiac status of patients that were being prescribed
Viagra®.”
Adrugrecall.com
21. Instructions to Physicians
£ Efforts by Pfizer:
£ Provided detailed prescription information
£ http://www.pfizer.com/files/products/uspi_viagra.
pdf
23. Recommendations
£ Imperative to impose stringent guidelines on physicians:
£ 1. Trained to detect underlying conditions instead of simply
prescribing Viagra to overcome ED
£ 2. Comprehensive evaluation & counseling of patient
25. Limitations
£ Issues of human sexuality are
complex & very personal-
might exceed physician’s own
knowledge & experience
£ Patients may not be completely
truthful
£ Atypical behaviours may be
downplayed
28. FDA & Viagra
So should the FDA require the pharmaceutical industry
to conduct more elaborate pre-market testing, or
increase monitoring of customers’ use of the drug?
30. Recommendations
£ More illustrative
sample groups in
clinical trials
£ More thorough
examination of those
with psychological
conditions that give
rise to ED
31. Limitations
£ Responsibility of
manufacturers to design
effective trials
£ Sample size & associated
costs
33. Monitoring Use of Viagra?
£ Currently only
“monitored” through
prescriptions
£ May infringe privacy
34. Ethicality
Although legal, is it ethical for drug manufacturers to
develop and market a drug that promises enhanced
sexual performance but could also cause life-
threatening side effects?
35. More consequences
18-45 years: 312%
45-55 years: 216%
£ Abuse
£ Dependency
£ “Alpha male” mentality
£ Side effects
Cons outweigh Pros thus far
36. Intention
£ Hard to quantify initially
£ But, it is possible that Pfizer aims to treat ED AND
make a profit
37. However…
£ Ethical if developed properly
£ Cannot rule Viagra out as some genuinely need it
£ ED is viewed as a very serious condition
£ Impacts lives of sufferers & those around them
38. Viagra is NOT a Wonder Drug
£ Line drawn between Pfizer, physicians, consumers
40. Credits & References
http://www.adrugrecall.com/viagra/label-change.html Prescribing Viagra In A Ethically Responsibile Fashion, by
http://www.pslgroup.com/dg/c5fa2.htm Eugene V. Boisaubin and Luarence B. McCullough,
http://www.consumerinjurylawyers.com/viagra/viagra-side-effect.html Of Medicine and Philosophy, Taylor & Francis
Journal
http://www.naturalnews.com/001668.html
http://www.bnet.com/blog/drug-business/pfizer-seeks-non-prescription-status-for-viagra-despite-health-risk-worries/4200
http://www.pfizer.com/files/products/uspi_viagra.pdf http://www.medicinenet.com/impotence_ed/page6.htm#v
http://www.usatoday.com/news/health/2001-03-21-viagra
http://www.answers.com/topic/viagra http://aids.about.com/cs/druginformation/a/viagra_
2.htm
http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0030132
http://www.emaxhealth.com/52/17244.html http://articlet.com/article10951.html
http://www.canada.com/cityguides/winnipeg/infostory.h
http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/default.htm
http://www.junkscience.com/news2/viagra3.html http://www.consumeraffairs.com/news04/viagra_ads.htm
http://www.thebody.com/content/art32246.html (The http://www.fda.gov/Drugs/ResourcesForYou/Consumers
Dangers of Using and Abusing Viagra, by David Salyer http://bodyandhealth.canada.com/drug_info_details.asp?b
http://www2.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/02-13-2006/0004280624&EDATE
http://www.drugs.com/viagra.html
http://www.pfizer.com/responsibility/working_with_hcp/working_with_hcp_benefits_patients.jsp