Talkin’ scope of practice

The gathering storm

In the wake of the pandemic and its expansion of the care pharmacists can provide to patients, there’s trouble a-brewin’ between the folks who have traditionally provided those services (and been paid to do so) and the pharmacists who are finally being recognized as true healthcare providers.

Pharmacy companies in particular feel they’ve proven what they can do in a crisis. They are seeking to capitalize on that, but the evolution of their business still depends on whether or not they can get paid for it.

Axios takes a broad look at all those brewing issues — and there are plenty.

Half empty, half full

The editor of Drug Store News worries that expanding pharmacists’ scope of practice — even though it’s objectively led to better outcomes — will lead to more bickering between pharmacists and physicians, and “is only the tip of the iceberg of a larger issue that is brewing between retail pharmacy and the medical community in the United States.”

Still, the magazine’s cover story (read it here — 4-page PDF) has a more positive spin and looks at the ways physicians and pharmacists can and should work together.

Semaglutide just keeps on giving

It’s not only a diabetes drug, a weight loss drug, a floor wax, and a dessert topping, now it seems semaglutide might treat alcohol dependence.

We wrote last month about anecdotes that it cut addictive behavior like shopping, gambling, and yes, drinking. Now Swedish researchers have tested that theory hypothesis on rats. They found that “[semaglutide] significantly reduced their alcohol consumption and even reduced the drinking of alcohol in conjunction with relapses. And by “significantly” we mean in half.

Of course what works on rats might not translate to humans, but when combined with those anecdotes it seems that something is going on. More tests will, of course, be needed to suss out the details.

Covid brain fog explained

Why does long Covid cause brain fog? It’s the signature symptom of the condition, but the cause is unclear. Aussie researchers, though, might have figured it out.

SARS-CoV-2, it seems, “can infect the brain and cause brain cells to fuse together and either malfunction or stop working completely.”

Yep, you can add “Are your brain cells fused today?” to your list of insults.

As an analogy, Professor Hilliard [of the University of Queensland] likened the role of neurons to that of wires connecting switches to the lights in a kitchen and a bathroom. “Once fusion takes place, each switch either turns on both the kitchen and bathroom lights at the same time, or neither of them,” he said. “It’s bad news for the two independent circuits.”

But wait, there’s more. From a scientific point of view it adds a third possible outcome to a viral brain infection: fusion (the others are cell death and inflammation). And it also explains other symptoms like loss of smell and headaches — and why the virus can still be detected in some patients months after infection.

Boosting cancer treatment

Some cancers are resistant to immunotherapy because a patient’s T cells aren’t up to the task of destroying them. As the news is teaching us, you can give an army an order but it won’t win many battles if it’s too weak to follow it.

But what can boost that T cell army are blood-pressure drugs. One of the drugs’ mechanisms, found Ludwig Cancer Research researchers, can alert T cells of abnormalities and trigger an immune response — waking them up and giving them a boost.

[A]longside their known hypotensive and anesthetic effects, α2AR agonists can also stimulate macrophages in their role as sentinels, making T cells more reactive and more effective at rejecting cancer cells.

They don’t recommend just adding BP drugs to immunotherapy because there are issues of toxicity. Instead, this is opening a door to a better cancer treatment once more research is done.

Non-pharma (but interesting) health news

New method means more hearts for transplant

A new method of heart transplants can make more organs available — maybe as much as 30% more. It’s already in use in some places around the country, and proponents would like it to be the new standard.

Rather than waiting for donors to be brain dead and putting their hearts on ice, the new method removes life support earlier — right after cardiac death — then removes the heart and uses a machine to keep it alive while it’s being transported. By not waiting until brain death, more hearts are viable and the pool of available organs increases — and even better, there’s a higher survival rate for recipients.

Detach today, have a better tomorrow

Had a long day? A rough one? If you want tomorrow to be better, you need to unwind properly — that’s according to a study out of Germany, where unwinding isn’t exactly a way of life.

The trick, based on interviews with and diaries of 124 people over more than two years, is using psychological detachment. In other words, disconnect from work — no emails, no texting the boss, no “I’ll just work a little…”. Detach.

“The findings indicated that that psychological detachment was indirectly related to the next day wakefulness, calmness, and pleasantness via sleep quality — meaning that detaching from work was linked to better sleep quality and sleep quality was related to positive mood states.”

It’s stuff like this that keeps Gwyneth Paltrow in business

Tennis star Novak Djokovic wears a patch that he (and the manufacturer) claim boost performance as “nanocrystals emit photons towards the body providing several health benefits.”

This is the guy who claims he’s gluten intolerant because a doctor told him he had less strength when holding a piece of bread.