Migraine spray gets thumbs-up

As expected, the FDA has approved Pfizer’s Zavzpret (aka zavegepant) — an anti-migraine nasal spray that works in minutes and can last for up to 48 hours … in trials, at least.

Of course there’s a downside: price.

A Pfizer spokesperson said Zavzpret “is expected to be comparable in price to other FDA approved CGRP migraine medications.” As an example, eight doses of Nurtec, another CGRP-inhibiting tablet taken daily to prevent and treat migraines, can cost over $1,000.

A Crystal congrats

A big ol’ GPhA shout-out to Crystal Pharmacy in Moultrie, named business of the month of March by the Moultrie-Colquitt County Chamber of Commerce!

Treatment for one dementia symptom

Some Alzheimer’s patients experience trichotillomania — the irresistible urge to pull at skin and hair. Now there appears to be a treatment beyond cognitive behavioral therapy: memantine.

University of Chicago researchers found in a small study that it works extremely well — “26 of the 43 study participants taking memantine had much improvement or very much improvement, compared to three of the 36 taking a placebo.”

They think it has to do with blocking the neurotransmitter glutamate (already seen as a culprit in some OCD cases), but as always, more research is needed.

The good news is that memantine is already FDA approved, so people suffering from trichotillomania might be able to convince their physicians to prescribe it off label.

Spring Region Meetings — mark your calendar!

Save your date for your local spring Region Meeting, coming next month. We’re still finalizing the locations, but there’s a good chance they’re in the same awesome eatery as the fall meeting. Stay tuned.

• Thursday, April 13: region 5
• Tuesday, April 18: regions 7/9 and region 11
• Wednesday, April 19: regions 1 and 10
• Thursday, April 20: regions 4 and 8
• Tuesday, April 25: regions 2/3 and region 12
• Wednesday, April 26: region 6

What’s your region? Click here for the map.

The law, the wholesalers, and the patients who can’t get meds

Controls implemented by pharmacy wholesalers are keeping patients from getting their medication — pharmacies are finding their supplies limited with wholesaler’s explanations kept secret by law.

It’s all fallout from the Big Opioid Settlement, but rather than simply hindering pill mills and drug abuse, it’s coming between legitimate patients and their pharmacies. Secret “triggers” limiting pharmacy orders for controlleds are at best confusing and frustrating, and at worst mean patients can’t get their treatment.

This one graf from the New York Times article explains it best:

The distributors use algorithms that cap the quantities of controlled substances a pharmacy can sell in a month. Before the settlement, pharmacists said, they could explain to a distributor the reason for a surge in demand and still receive medications past their limits. Now the caps appear to be more rigid: Drugs are cut off with no advance notice or rapid recourse. As a condition of the settlement, distributors cannot tell pharmacies what the thresholds are.

The 15 big guns

Adam “Drug Channels” Fein has released his annual list of the 15 biggest pharmacies in the country. There are zero surprises, but feel free to check it out.

New hep-B guidelines

[insert news-ticker sound here] The CDC has made a “significant update” to its hep B recommendations. It now says everyone should be screened at least once in their life, and pregnant women should be tested with the extra-fancy triple panel screening. Those at risk — incarcerated, multiple sex partners, history of STIs — “should be tested periodically if they remain unvaccinated.”

Of course, if you weren’t vaccinated as a child, it’s a good idea to get a shot, especially if you’re in (or plan to be in) one of those risk groups.

“I’m not sleeping, boss, I’m making sure my vaccination works better”

Guys: Be sure to sleep before you get your shots. It seems that poor sleep the night before getting a vaccination could mean it doesn’t work as well — but only for men.

That’s what University of Chicago researchers discovered when they did a meta-analysis of studies on flu and hepatitis vaccines, but it applies to any vaccine.

[I]f a person arrived for a Covid-19 vaccination without adequate sleep, their antibody response to the vaccine would be weakened by the equivalent of two months […] “You would have already lost two months of immunity, so to speak, even though you just got the shot.”

Why does this only affect men? They just don’t know.

Short Takes

 

Short visits, wrong drugs

A study in JAMA Health Forum finds that the shorter a primary care visit, the greater the likelihood that a patient will get an unnecessary antibiotic for a respiratory infection. “The authors say that finding suggests that when clinicians have more time to discuss a diagnosis with patients, they are less likely to reach for a quick fix.”

Shades of thalidomide

If, back in the ’60s and ’70s, your mother used dicyclomine (part of Bendectin) for nausea while she was pregnant with you, you might have a higher risk of colorectal cancer. That’s based on patient records, though, so the University of Texas researchers who discovered this say that — you know it — more studies are needed to figure out the cause and effect.