Fentanyl is an extremely powerful opioid painkiller that is 80 to 100 times stronger than morphine. It was approved by the U.S. Food and Drug Administration (FDA) for the treatment of late-stage breakthrough cancer pain in adults who are opioid tolerant or who have developed a tolerance for opioid medications as a result of long term treatment.
Cancer patients would definitely be familiar with some medications, like: Actiq, which is in lozenge form; Duragesic, which is in the form of a skin patch; Abstral, a sublingual tablet or a tablet that goes under the tongue; Fentora, a tablet that goes between the gum and cheek; and, Subsys, a sublingual spray.
Subsys, the most recent fentanyl-containing medication placed under legal spotlight, is manufactured, and was introduced in 2012, by drugmaker Insys Therapeutics, Inc. During the first half of 2015, this drug netted a $147.2 million profit for Insys, making it one of the biggest selling highly-addictive painkillers in the U.S. and around the world.
Use of Subsys, however, like all other fentanyl-containing drugs, poses great risk due to the possibility of abuse, misuse, addiction and overdose; using it on children can be fatal too. Due to the risks it presents, the FDA has Subsys mandated that it can only be prescribed (by healthcare professionals) and acquired (by patients) by enrolling in the Transmucosal Immediate-Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS) Access program, a restricted program of the FDA.
It may be true that Subsys effectively and immediately controls breakthrough cancer pain; despite being effective, however, reports have surfaced which link this drug to about 203 deaths since it was introduced in 2012. This is besides the 52 Subsys-related deaths reported in the second quarter of 2015.
The risks, the deaths, plus allegations that Insys Therapeutics has illegally prescribed Subsys for off-label use (the major reason for the many cases of fatal overdose in individuals who are not suffering from cancer and, therefore, not opioid tolerant) has landed this drug in the “drugs of concern” list kept in the office of the U.S. Department of Health and Human Services’ Inspector General.
Patients who have been inappropriately prescribed with a powerful opioid medication, such as Subsys, can suffer serious and potentially fatal injuries, such as overdose. Seeking legal assistance from a highly-skilled Subsys spray attorney may be able to help the victim and/or his/her family pursue justice and the compensation he/she may be legally entitled to.
No matter how smooth flowing your plumbing system is, it is still bound to encounter some problems occasionally. While you can do some plumbing works yourself, there are times when letting the professionals handle such kind of jobs is the best option. According to the website of American Leak Detection of Dallas, some leaks are hidden that it will require an expert to locate them. So when is the best time to dial a plumber?
- When the main line has stopped
Repairing the main line of your plumbing system entails the use of special equipment which only plumbing companies have.
- When there are leaks in your walls, basements, or bathrooms
When water damage creeps in along your ceiling, walls, or floors, there might be a leaky interior pipe. These types of damage can lead to a more serious problem. So before it gets worse, call a plumber to locate, fix, or replace the leak.
- Your shower valve needs to be replaced
Choosing the right shower valve can be complex and time consuming if you do not have the experience. A professional plumber has the skill in changing the valve with minimal damage to your walls.
- Slow or Totally Clogged Drains
Slow or completely clogged drains can lead to serious problems. Attempting to find the cause of the problem yourself is a recipe for disaster. A plumber has the training, skill, and equipment for removing clogs without damaging your pipes.
Do-it-yourself plumbing can indeed save you plumbing repairs expenses. However, it can become a huge problem if you attempt to do the plumbing project yourself. By letting the professionals do their jobs, you can have some peace of mind when it comes to leaks and other plumbing-related issues. What’s a hundred bucks compared to having leak issues here and there.
As instituted by the Federal Motor Carrier Safety Administration (FMCSA), those who carry a commercial driver’s license (CDL) are held at a higher regard than those who have non-commercial driving licenses when it comes to driving under the influence. This is because regardless of what they are driving, commercial drivers present a serious danger to the safety of the public as well as become a major liability to their respective employers.
The majority of states in America has taken up the strict FMCSA regulations regarding alcohol levels for commercial drivers. Set at half the blood-alcohol concentration limit of non-commercial drivers, commercial drivers should have less than .04 percent BAC limit. Furthermore, those who have consumed alcohol are not allowed to drive a vehicle within 4 hours after they have consumed alcohol. This is to ensure that they will not be a risk on the road and prevent any road accidents.
The effects of being charged with commercial DUI can be extensive. According to Ausband & Dumont, aside from being subjected to the same procedures as non-commercial drivers, those who have been charged with commercial DUI can face a lengthy license suspension. This could lead to loss of employment and financial struggles for the driven and their family. Additionally, those who have been convicted of DUI (regardless of whether he was on duty or not at that time) has to inform their employer about the court’s decision and their license suspension or revocation. The employer should prevent the CDL-driver from operating until the end of their license restriction. This often makes re-employment very difficult for the driver because the DUI conviction is already on their records.
There are many ways with which a commercial driver will be required to take a random alcohol test, such as a when there is viable suspicion, after an accident, or as part of the requirements to return from work after a suspension. FMCSA additionally requires drug testing as part of a condition for employment, after an accident, when there is feasible suspicion, and as a prerequisite to go back to work. Refusing to submit to any of these tests can lead to a more severe penalty, and could lead to a guilty plead for DUI according to FMCSA rules.
After the initial Volkswagen scandal discovery of millions of cars outfitted with software to avoid strict emissions regulations, the chief executive of the German auto manufacturer Martin Winterkorn resigned. His replacement was announced on September 25 as head of Porsche, Matthias Muller. Along with the announcement of the new chief executive came companywide changes that are intended to repair damage to the company after “Dieselgate.”
The effects of the Volkswagen software that duped emissions tests on the diesel models is yet undetermined. The environmental impact is considered to be substantial with 11 million vehicles around the world emitting nitrogen oxides 10 to 40 times above U.S. legal limits, according to the the website of the Driscoll Firm. This was done by the “defeat device” inserted into diesel passenger cars that sense when a vehicle is being tested rather than driven on a road, triggering the vehicle emissions to regulation levels.
Berthold Huber, the chairman of the company’s supervisory board called the incident “a moral and political disaster.” Under the new chief executive, removal of several leaders in connection to the scandal is underway. Among the suspended individuals is Christian Klingler, the former top sales and marketing executive at Volkswagen. As stock and sales continue to drop around the globe, Volkswagen hopes that the new leadership will promote the regrowth of trust.
One of the main concerns for consumers is in regards to compensation that that former Chief Executive Martin Winterkorn promised was coming. Volkswagen made a statement assuring that $7.3 billion dollars was set aside for VW diesel passenger vehicle owners affected by the scandal. In the wake of falling estimated values of affected vehicles, many drivers are upset that they were deceived into harming the environment and are now possess fraudulent vehicles. However no plan has been released to the public on how these funds will be distributed to the car owners. However no plan has been released to the public on how funds will be distributed to the car owners.
Many of the regular dog food brands you will find in the supermarket are much cheaper than the all natural dog food varieties available. This is mainly because regular dog foods are often made up of a lot of fillers and food scraps from meat, poultry and produce processing plants that would otherwise be thrown out. It can be tempting to go for price rather than quality, but it may cost you more in the end. Here are 5 benefits you can get from an all natural dog food diet.
An all natural food diet especially formulated for dogs takes into consideration the needs of your pet. Dogs are not people, and there are some foods that they simply cannot digest. Grains such as wheat, corn and soy found in regular dog food acts as a stopper, keeping essential nutrients from being absorbed by the body. The dog becomes lethargic and obese and may even develop digestive problems.
Healthier coat and skin
Dogs can develop allergies to artificial preservatives, flavors and colors used in regular dog food. It manifests in skin rashes, excessive shedding and digestive upsets. All natural dog food formulas by definition do not include these ingredients.
Fewer trips to the veterinarian
When a dog gets the right kind of nutrition, there is no reason why a visit to the veterinarian is necessary save for an annual check-up, immunization shots and the like. A healthy dog saves you money on vet visits, medical procedures and medications.
No need for supplements
Most of the good-quality all natural dog food brands incorporate the essential vitamins and minerals needed by dogs as recommended by the Association of American Feed Control Officials (AAFCO). If you buy the right dog food for your dog’s particular breed, size and age and follow the feeding guidelines, then you will not have to buy supplements separately.
Happier pet and pet owner
Good quality all natural dog food is more expensive but the savings from having a healthy dog all the time will more than make up for your investment. Moreover, healthy dogs are generally happy, well-adjusted and alert, and that makes pet owners happy as well.
According to The Rugged Pup, for best results you should gradually acclimate your dog if you are switching to an all natural dog food diet. This will ensure that the transition is smooth and mess-free, and prevent intestinal distress.