Mifepristone vs aging

Well this is interesting. Mifepristone might have an interesting new indication — it might help extend lifespan.

You might know that rapamycin has been shown to help animals live longer. Well it seems, according to USC researchers, that mifepristone works the same way. Both drugs increase mitophagy — the cellular cleanup process that tends to break down as we age. By keeping mitophagy working properly, poorly functioning mitochondria continue to be removed so they can be replaced by working versions.

As the lead researcher points out, because the drug is already FDA approved, clinical trials of its anti-aging effect will be easier.

The best BP managers

When it comes to helping patients lower and control their blood pressure, which kind of healthcare provider do you think does best?

If you said anything other than “pharmacist,” you’re reading the wrong newsletter. A meta-analysis out of Tulane University (that included data on 90,000 patients) found that …

while all the groups studied who led BP control efforts were successful in reducing BP, pharmacist- and community health worker–led teams saw the biggest reductions.

Actually, pharmacists were #1 — their efforts resulted in an average systolic BP drop of 7.3 mm Hg. Physicians and nurses? They got less that half that.

Antibiotic-resistance twist

This is not good: Australian researchers have documented the first case of one antibiotic (rifaximin) resulting in bacteria resistant to a different antibiotic (daptomycin).

The study — published in Nature — found that rifaximin, an antibiotic used to treat liver disease, causes resistance to another antibiotic, daptomycin.

Worse, this means that antibiotics considered “low-risk,” like rifaximin, might not be — as well as suggesting that other antibiotics might be resulting in resistance outside their class.

Microscopic medicine

4-in-1 robot

We’ve written about microscopic robots before, but here’s a new one: The size of a grain of rice, it can actually carry “four types of drugs with reprogrammable drug-dispensing sequence and dosage.”

So yeah, it can not only carry multiple drugs and be steered (via magnetic fields) to where it’s needed, it can be programmed to release those drugs in the right sequence and at the right dosage — kind of like the UPS driver making deliveries to one location after another.

Goldilocks medication

Check this out: Imagine an antibiotic you could take that would only be activated when a specific bacteria was present. That would ensure that the bare minimum of drug was used, reducing the risk of antibiotic resistance.

Imagine no more! Canadian pharmacy engineers have developed just such a … pill?

This new technology consists of fatty compounds invisible to the eye that are tailored to only release a drug in the presence of toxins produced by specific types of bacteria.

Once the target bacteria is eliminated, any excess medication is broken up and excreted so “the patient doesn’t take too much medication and the body is not constantly exposed to the drug.”

A slightly better OUD treatment

When dealing with opioid use disorder, giving patients methadone — rather than either buprenorphine or naloxone — results in them being less likely to quit treatment.

Based on 10 years’ worth of records of almost 31,000 people, Canadian researchers found that more patients stayed in treatment if they were given methadone. To be fair, despite the headline (“Methadone much more effective…”) neither treatment was amazingly effective, but methadone was less ineffective:

• Patients taking buprenorphine/naloxone were 88.8% likely to stop treatment within 24 months.
• Patients taking methadone were only 81.5% likely to stop.

The Long Read: Pharmacists as Police edition

“What We Lose When Pharmacists Are Forced to Act Like Cops”

Pharmacists are trained to think in terms of medicine, but the opioid crisis pushed them to think in terms of crime.

[…]

Today, however, pharmacists regularly police patients by reframing enforcement practices as care. One pharmacist told me that he now views his role as that of a gatekeeper, tasked with making sure patients are not misusing or selling drugs.