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<P><B>PFLI note: </B>The following is an email exchange between PFLI
president Karen Brauer, RPh, MS and Washington Post reporter Rob
Stein. Private information has been removed but otherwise this is a
faithful representation of the exchange.</P>
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<P><B>Subject: </B>Ulipristal Re: Washington Post query</P>
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<P><B>Date: </B>Tue, 01 Jun 2010 18:16:18 -0400</P>
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<P><B>To: </B>Rob Stein
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<P><BR>Rob,<BR><BR>The mechanism of action of ellaOne<FONT FACE="Tahoma, sans-serif">®</FONT>
(generic name: ulipristal), is much more like that of mifepristone
(trade name: Mifeprex<FONT FACE="Tahoma, sans-serif">®</FONT><FONT FACE="Tahoma">;
experimental name: RU 486)</FONT>. At this time there are
conflicting stories concerning how it would operate as a
morning after pill, but the fact that it works for FIVE
days after intercourse, and the efficacy does not seem to degrade
with increase in time after intercourse, means that it's pretty
obvious. This one is more prominently an abortifacient
than the morning after pill.<BR><BR>Fewer health care entities will
be able to pretend that this one is not working by post fertilization
effects. (Many apologists explain away this portion of the
mechanism of Plan B by citing its extreme
unreliability/ineffectiveness)<BR><BR>Ulipristal is seen as being not
much more effective than Plan B One-step. There might be a
claim in the future for ulipristal, as has been seen with
levonorgestrel in Plan B. <BR><BR>For the time being, the
studies show a dose dependent inhibition of ovulation as well as
fetocidal effects. In animal studies-- as the dose
is increased (well ABOVE the dose planned for
administration as a "morning after" pill) ovulation can be
inhibited, as well as <I>fetuses </I>killed. <BR><BR>It's all
in the <A HREF="http://www.who.int/immunization_standards/vaccine_regulation/article_58_guidelines_0505.pdf">CHMP
Assessment Report.</A> <BR><BR>For pharmacists, it's more
of the same, only with a more easily recognizable and more
prominent interceptive/abortifacient effect than the hormonal birth
control modalities. With this drug, it will be more possible to
accumulate doses and accomplish actual over the counter (OTC)
abortions of already implanted human embryos. More pharmacists
will think about refusing this drug as it might take longer for
the apologists to excuse away the post fertilization mechanisms.
Also they might recognize the high potential for off label use for
later abortions<BR><BR>There are already telemed abortions occurring
in Iowa, and mifepristone is available on the black market all over
the world. <BR><BR>Ulipristal is not a major shock wave
to those who knew that mifepristone itself was already being
used as a morning after pill in other countries. It is more of
a shock to those who are just learning about these issues. <BR><BR>In
combination with the policies of government controlled health care,
it will help to reduce the availability of legitimate health care
overall. <BR><BR>With the telemed abortions and the
introduction of this drug, the United States abortion industry
will have gone full circle, from pretending to prevent unsafe,
do-it-yourself abortion, to being the obvious facilitators of the
very same thing. <BR><BR><BR>KB<BR><BR><BR>Karen L Brauer
MS, RPh<BR>Pharmacists for Life
International<BR><A HREF="http://www.pfli.org/">http://www.pfli.org</A><BR><A HREF="http://themorningafter.us/">http://themorningafter.us</A><BR><BR><BR>
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<P><FONT SIZE=3>PS...Karen responded to further questions by Mr
Stein:</FONT></P>
<P><FONT SIZE=3><B>RS: Thanks! Do you think this will cause more
problems for pharmacists who won't want to fill prescriptions for
it?</B></FONT><FONT SIZE=3><BR><BR>KB: This is really just more of
the same, but with some additional pharmacists coming on board to the
prolife side.<BR>The video evidence as well as attendance at
gatherings show a more conservative base coming up from high school
and college age kids, and many of them are to the right of me, so I
expect more career shifting and dissent based upon the push to make
pharmacists dispense unethically. <BR><BR><BR>RS: </FONT><FONT SIZE=3><B>Also,
what would say to those who argue that pharmacists are obligated to
fill all prescriptions?</B></FONT><FONT SIZE=3><BR> <BR>KB: The
unfortunate thing is that their demand for health care professionals
to behave as slaves, and not as humans with rights of conscience will
degrade the quality of health care for everyone else. <BR><BR>The
conscience drives the health care practitioner towards assiduous care
of the patients, and excellence in practice.<BR><BR>Having practiced
in retail, nursing home, and hospital pharmacy, and having had
countless opportunities to correct potentially fatal errors in
all those settings, I understand that health care without
pharmacists will be severely degraded in quality.
To insist that pharmacists fill all prescriptions is denial of the
need for their most important job functions to correct malpractice
and errors in prescribing. <BR><BR>Natural selection might
take care of this denial problem eventually.<BR><BR>Linked below
is the </FONT><FONT SIZE=3><B>January 2010 blurb on ellaOne on
my personal (amateur) news blog.</B></FONT><FONT SIZE=3> </FONT>
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<P><A HREF="http://themorningafter.us/bogus-medical-news-novel-morning-after-pill-works-for-five-days-in-obgyn-pregnancy-from-medpage-today/"><FONT SIZE=3>http://themorningafter.us/bogus-medical-news-novel-morning-after-pill-works-for-five-days-in-obgyn-pregnancy-from-medpage-today/</FONT></A><BR><FONT SIZE=3><BR></FONT><BR><BR><BR><BR>Rob
Stein wrote:
</P>
<BLOCKQUOTE><BR><FONT FACE="sans-serif"><FONT SIZE=2>Hi,</FONT></FONT>
<BR><BR><FONT FACE="sans-serif"><FONT SIZE=2>I'm working on a story
about a drug company that is trying to get a new drug approved for
use as an emergency contraceptive. It's called ulipristal. I was
wondering what your thoughts might be able what the approval of this
drug might mean for pharmacists.</FONT></FONT> <BR><BR><FONT FACE="sans-serif"><FONT SIZE=2>Thanks,</FONT></FONT>
<BR><FONT FACE="sans-serif"><FONT SIZE=2><BR>Rob Stein<BR>The
Washington Post<BR>202-334-7338 phone<BR>202-496-3883
fax<BR><A HREF="mailto:steinr@washpost.com">steinr@washpost.com</A><BR><BR><A HREF="http://blog.washingtonpost.com/checkup/">http://blog.washingtonpost.com/checkup/</A></FONT></FONT></BLOCKQUOTE>
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