Meds, heat, and body temp

Here’s an unexpected twist: Some medications — including blood thinners and blood pressure drugs — can make it harder for the body to regulate its temperature in hot weather.

Researchers in Singapore published a review paper that looked at how various medications, including insulin, metformin, SGLT2-inhibitors, antiplatelets, and more, affect people in the heat. They found that those meds “can make it harder for the human body to handle hot weather by reducing its ability to sweat or increase blood flow to the skin.”

This is just a preliminary look at the data, but they make a point that ‘understanding the health impacts of drugs, especially during prolonged and extreme heat exposures, remains a crucial gap to be filled.’

Last call for Braves tix!

Get off the fence and out to the ballpark — join GPhA staff, members, and friends and tens of thousands of Braves fans at the third annual GPhA Day at the Braves game!

It’s Sunday, September 10 at 1:35 pm when the Braves take on the Pittsburgh Pirates!

Tickets must be purchased no later than this coming Sunday, August 27.

We’re all together in Terrace Reserved Section 240. Tix are only $50 per person.

DON’T MISS OUT!

 

Antipsychotics work by collateral damage

Antipsychotics are notoriously hit or miss. We know they work by targeting what’s called the D2 receptor on certain neurons, which helps turn down the brain’s dopamine system.

Um … actually, that turns out not to be the case.

Instead of turning up the action on D2 receptors, it seems that better drugs work by turning down the action on their cousins — D1 receptors. But no one paid attention to what was happening to those D1 receptors, in part because until recently we didn’t have the molecular-level tools to do that.

But then came neuroscientists at Northwestern University, who were able to look deeper and find that — oops! — the real action was happening over at D1 all along. That’s why D2 drugs are hit-or-miss; no one was looking at how they affected D1 receptors.

That, say the Northwesterners, is why clozapine works. It (serendipitously!) suppresses D1 cells, which could somehow “explain its clinical superiority, particularly for treatment-resistant schizophrenia.”

If they turn out to be right, that’s good news for people with schizophrenia, but “upends decades of research in a $15 billion market for drugs that are famously erratic.”

Sure, why not?

Researchers at Australia’s James Cook University found that hookworm infection might treat insulin resistance — heading off type 2 diabetes at the pass. Yes. Hookworm infection.

I’m just gonna quote from the story because it pretty much says it all:

Participants were inoculated with either 20 or 40 infectious larvae of the human hookworm species Necator Americanus or a placebo.

After two years, participants were offered a deworming medication or could elect to stay in the trial for a further 12 months. All but one of the infected participants […] decided to keep their worms.

Aussies, am I right?

Results of the study […] indicated that hookworm infection was safe and well-tolerated, and had a beneficial impact on metabolism, inducing a clinically significant reduction in insulin resistance levels in most trial participants.

E-cigs can help quitting

It’s time to flip the “Vaping: Good or Bad?” coin again, with the latest results out of the Medical University of South Carolina. This one says ….

[insert drumroll here]

Yes, they do help smokers quit.

This new study, the largest trial of e-cigarettes in the U.S., showed that e-cigarette usage nudged people toward quitting smoking – even people who had entered the trial saying they had no intention of quitting.

(Of course, this study looked at existing smokers. The other side of the double-edged sword is that e-cigs can start non-smokers down the road to nicotine addiction and cigarettes.)

Who wants pi? No one. No one wants pi

Just as the Eris strain of Covid is making its mark (with about 20% of cases in the US) along comes “Pirola,” aka BA.2.86.

The big deal: Eris and the entire XBB alphabet have been subvariants of Omicron. But Pirola looks like the first of the next variant: Pi. It’s already confirmed in Michigan, which means it’s likely spread farther.

Right now Pirola is a “variant under monitoring” by the WHO, which isn’t as bad as a “variant of interest” or worse, a “variant of panic.”

BA.2.86 […] features 30 or more mutations that separate it from other Omicron — mutations with the potential to make it considerably more immune-evasive, and able to more easily infect cells.

Rinse, spit, diagnose

If your saliva has too many white blood cells, that could be an indicator of impending heart disease. That’s because white blood cells mean gum inflammation, gum inflammation leads to periodontitis, and periodontitis is linked to heart disease.

And all that means, say researchers at Canada’s Mount Royal University, “A simple mouth rinse could spot early heart disease risk.”

The Long Read: Long-Term Damage edition

The US pays more for prescription drugs than any other country. That’s old news. A reminder, though: A lot of that comes from a single bill and massive pharma lobbying: the 2003 Medicare prescription drug act that created Part D. At 3:00 am, and under intense (and we mean intense) pressure from the pharmaceutical industry, the bill included a provision forbidding Medicare from negotiating the price of drugs. The rest is expensive history.

CBS covered the effect of the bill’s passage in 2007.

Before the vote, Congress was told the program would cost a whopping $395 billion over the first 10 years. In fact, Medicare officials already knew it was going to cost a lot more.

[…]

Medicare Chief Actuary Richard Foster later told Congress that he revised the cost estimate to $534 billion before the vote, but was told to withhold the new numbers if he wanted to keep his job.