OTC naloxone: first step

Naloxone could soon be officially over the counter, as the FDA has started the process by saying, “Yeah, it makes sense. Let us think about it.”

The FDA is starting the process by requesting public comment on the idea (open till January 17, 2023). Right now a lot of states, including Georgia, have standing orders allowing pharmacists to dispense naloxone without an individual prescription. (More info on Georgia’s is here.)

If the FDA decides to move forward, it would only cover lower-dose nasal sprays and auto injectors, and it would require manufacturers to submit their individual products for review as potential OTC drugs.

Fewer children of men

Sperm counts around the world have been dropping for the past 50 years, and the rate of the droppage is accelerating. And no one knows why.

From 1973 to 2000, sperm counts dropped by 1.2% per year […] From 2000 to 2018, the decline was 2.6% per year, “which is an amazing pace.”

A better way to deliver chemo to the brain

If you want to deliver chemo drugs to treat brain cancer, that pesky blood-brain barrier is in the way. We’ve written about various ways to get through, including ultrasound and nanotechnology. Or you can simply flood the body with chemo and hope some gets through before the side effects are too much.

But Columbia University neuroscientists decided to try something a bit more direct: implanting a pump and sticking a tube directly into the brain. (Implanting the pump cuts the risk of infection.)

“If you pump in the drug very slowly, literally at several drops an hour, it penetrates into the brain tissue. The drug concentration that ends up in the brain is 1,000-fold greater than anything you are likely to get with intravenous or oral delivery.”

They tested the system on animals (it worked) and then on humans (it worked) — “MRI scans showed that chemotherapy had saturated the area in and around the tumor.”

Next up: More human trials.

What’s the best plan for taking bisphosphonates?

Bisphosphonates like zoledronic acid and risedronate are important for treating osteoporosis, but long-term use can lead to side effects — and that can lead to patients quitting them. Is that the right call?

The good folks at Georgia’s Augusta University are working on an answer. They’re creating a tool called CLUB — calculator for length of use of bisphosphonates — that uses…

…big, diverse datasets of males and females who have been using these drugs to objectively assess the risk and benefit of continuing to take bisphosphonates versus taking so-called drug holidays

In this case, big means half a million people. Once the data are in, CLUB will spit out a recommendation for whether to take bisphosphonates, continue taking them, or take a break (figuratively, that is). “We want to provide more individual evidence of your risk, not a population’s risk.”

Pfizer is ready for the flu pandemic

“The scientist behind Pfizer’s Covid vaccine says a flu pandemic is only a matter of time,” but don’t worry — the company will be ready to create and supply vaccines and treatments … once the federal government provides its credit card number.

Always read past the headlines

The headlines:

The reality — and to be clear, we’re not endorsing smoking anything — is that a small Canadian study found that 67% of tobacco smokers had emphysema, while 75% of tobacco-plus-marijuana smokers did.

But why? It’s not the marijuana, it’s the process: 1) marijuana cigarettes are unfiltered, and B) smoking a joint means holding the smoke in longer. So be nice to your lungs and stick to Grandma’s special brownies.

A possible future for mental-health drugs

Austrian and Floridian scientists think they have a better way to treat depression and anxiety than traditional SSRIs. Rather than block the reuptake of serotonin, they found a way to release more of it.

“But wait,” I hear you say, “We already have serotonin-releasing compounds. We have ecstasy.” True, but — in case you haven’t heard — MDMA and its kin have some unwanted side effects. (You can see them occasionally on the evening news.)

What the Austrians have found are “the first representatives of a new serotonin-releasing class of drugs that do not produce various adverse effects.” They’re from the cathinone family, and their superpower is releasing serotonin without significantly increasing dopamine levels — more power, less abuse.

Research is ongoing.

An interesting way to treat liver disease

The bad news: Your liver is riddled with disease and you might need a transplant.

The good news: We might be able to treat you … with leprosy parasites.

Scientists have discovered that parasites associated with leprosy can reprogramme cells to increase the size of a liver in adult animals without causing damage, scarring or tumors.

The bad news: So far this is only true if you’re an armadillo.

The Long Read: Vaccine Predictor edition

How well will an individual respond to a vaccine? It turns out that many vaccines elicit a common signature when they’re working. That’s a Pretty Big Deal, because it could lead to test to determine how well a person will respond to a vaccine, rather than guessing based on the entire population.

Check out “Can We Predict How Well Someone Will Respond to a Vaccine?” from The Scientist.