Narcan goes OTC

The FDA has approved the first OTC version of naloxone — a 4mg nasal spray of Emergent BioSolutions’ Narcan.

When will your wholesaler have it? “The timeline for availability and price of this OTC product is determined by the manufacturer.”

Of course, one of the issues with an OTC Narcan is affordab

[Insert boilerplate description of the opioid crisis here, along with how naloxone is used — all stuff you already know.]

In other OTC news

An FDA advisory committee is scheduled in May to discuss making certain birth control pills available over the counter (Perrigo’s daily Opill). It has the enthusiastic blessing of medical organizations across the country, including the AMA, which has been pressing for at least five years.

Another May committee meeting will consider a nasal-spray version of epinephrine from ARS Pharmaceuticals.

Swinging the other way

A bipartisan group of US senators and representatives is calling for the animal tranquilizer xylazine to be designated a controlled substance “to better allow authorities to track it and prosecute traffickers.” (That link is for Republicans. Democrats click here.)

Xylazine, aka “tranq,” is being mixed with opioids with the idea of giving some kind of better high. Unfortunately, it’s likely to “depress breathing, blood pressure, heart rate and body temperature to critical levels,” according to the Substance Abuse and Mental Health Services Administration. It can also lead to a job as an extra on “The Last of Us”:

Additionally, people who inject drugs containing xylazine can develop severe skin wounds and patches of dead and rotting tissue that easily become infected and, if left untreated, may lead to amputation.

Finding connections

Bacteria that causes MS

A gut bacteria called Clostridium perfringens could be a trigger for the onset or relapse of multiple sclerosis.

A multi-university study found that the C. perfringens produces a toxin that “opens the blood vessels of the brain allowing inflammatory cells to gain access to the central nervous system and cause demyelination characteristic of MS.”

Confirming the connection, they found higher levels of it in the intestines of people with MS. The question is, can they use this information to create a treatment? Time will tell.

Overactive immune systems and osteoarthritis

People with asthma or eczema are more likely to develop osteoarthritis, found Stanford researchers, “signaling that there may be an allergic pathway that can be targeted with existing drugs.”

It’s a pretty strong correlation, too.

The authors found that if a patient had asthma or eczema, there was a 58% increased risk of developing osteoarthritis over about 10 years. If they had both asthma and eczema, the risk increased to 115%.

It’s all about tryptase, which can be released (along with histamine) by mast cells. In other words, osteoarthritis is essentially caused by inflammation from an allergic reaction. And with both asthma and eczema involving overactive immune systems, it makes sense that having one might cause the other.

Next step: Testing existing asthma meds as a treatment for osteoarthritis.

Body-powered insulin delivery

German engineers have created a nifty implantable device to treat type-1 diabetes. Nifty on two counts. First, it’s able to use the body’s own glucose to generate the power it needs — no batteries required.

Second, the fuel cell turns on when it detects excess glucose

As soon as the fuel cell registers excess glucose, it starts to generate power. This electrical energy is then used to stimulate the cells to produce and release insulin into the blood. As a result, blood sugar dips to a normal level. Once it falls below a certain threshold value, the production of electricity and insulin stops.

This is just a prototype at this stage — it works in mice. Bringing it to market will require “an industry partner with the appropriate resources and know-how.”

The Long Read: Influenza D edition

It’s out there. Mostly in cows, but in other mammals too — including people who work with animals, such as dairy farmers.

“This doesn’t seem to be something, right now, that the general public is exposed to in a large way. But it’s something that’s a concern for these front-line workers exposed on farms.” [And] there’s a real risk that the virus could adapt to people as more and more workers are infected.

Short Takes

At-home flu and Covid test

California-based Lucia launched its combo flu/Covid test for home use. While Covid tests are common, this is first time patients can test for influenza A or B at the same time.

The test involves nasal swabbing and runs on two AA batteries, delivering a result in about 30 minutes. The introductory price is $34.99, and the product is available on the company’s website.

If you’re into aspirin’s chemistry…

… then you might be interested in what University of Texas researchers have discovered about how the drug actually works — something we’re still not 100% certain of. (Warning: Definitely not for non-chemists.)

The team found that aspirin controls transcription factors required for cytokine expression during inflammation while also influencing many other inflammatory proteins and noncoding RNAs that are critically linked to inflammation and immune response.