Boosters: Keep this in mind

Yes, we’re all tired of reading about Covid-vaccine boosters, so I’ll keep this info quick (and you may already know it): Remind your patients that the forthcoming boosters are for people who have already had the original vaccine shots — they are low-dose boosters, and won’t do much on their own.

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This October, get your CE from slices of pharma history!

GPhA breaks out the creepy font with Pharmacy Tales from the Crypt: Four CE courses that connect history with today’s pharmaceutical world.

From the story of the first use of anesthesia — it was a UGA grad! — to Agatha Christie’s love of poison and more, at just $16 each for GPhA members ($19 for non-members) it’s a great dose of creepy continuing ed.

We couldn’t get permission to use Savannah’s Colonial Park Cemetery, so these are all taught via Zoom. Light your candles, find your cloak, and sign up today at GPhA.org/crypt.

Some pigs

If someone is diagnosed with the flu this year, the CDC would like healthcare providers to ask one simple question: “Were you at a state or county fair recently?”

Why? Pigs. Exposure to pigs might mean they’ve got themselves infected with a different flu variant, and — for obvious reasons — CDC would like to keep tabs on that.

Five cases of human infection with influenza viruses that usually spread only in pigs, also known as variant influenza virus infections, were reported to CDC in August 2022.

PS: If this made you call out, “Hey, when’s the state fair this year, honeybuns?”, the Georgia State Fair runs September 30 to October 9 in Atlanta.

Engineering a drug factory

The anti-cancer drug vinblastine has had supply problems — it comes from a lovely flower called the Madagascar periwinkle (aka rose periwinkle). Making the med requires a lot of flowers — “500 and 2,000 kilograms of dried Madagascar periwinkle leaves to produce one gram of vinblastine and vincristine, respectively.”

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Vinblastine is a “monoterpenoid indole alkaloid” (MIA) — great stuff, but impossible to create synthetically. Until some shifty Danes arrived on the biomedical scene: They engineered a yeast that can make the same precursor molecules as the plant, and do it faster, cheaper, and in an environmentally friendly way.

Even better, now that they have the basic system working, they can expand it.

“In addition to vinblastine, this platform will enable production of anti-addiction and anti-malarial therapies as well as treatments for many other diseases.”

Vaccine pill moving along

A small biotech company in California, Vaxart, says its Covid-19 vaccine pill did well in a small stage-2 (‘Does it work in humans?‘) trial. It’s the first oral vaccine to get this far, and the even-better news is that it works against at least some Omicron variants. Or strains. Or whatever you call the BA-this/that.

Larger studies are planned before it moves to phase 3 (“Is it safe?”) trials, perhaps in 2023.

Refreshing an old lung cancer drug

Some of you might remember cyclophosphamide — an drug for small cell lung cancer that disappeared in the 1980s. Its big issue was that cancer developed immunity pretty quickly.

But this is 2022, and Washington University researchers have discovered how cancer was able to block cyclophosphamide. And then they found a way to keep the cancer from doing that.

The way-too-short version: Small cell lung cancer has high levels of a protein called SMYD3, which helps them repair damage. Inhibiting the SMYD3 slows the tumor growth. But inhibiting it and treating it with cyclophosphamide “stopped the tumors in their tracks.”

This is only in mice so far, but as cyclophosphamide is already approved (if old), they’re already looking to start human trials of the inhibitor/cyclophosphamide combo.

“People with small cell lung cancer are in desperate need of better treatments, and I’m very excited about the possibilities here.”

The scary way fentanyl kills

Why is fentanyl so deadly? Because — and yes, this is as creepy as it sounds — “the drug stops people’s breathing before other noticeable changes” before they lose consciousness.

Investigators at Mass General found that …

… fentanyl begins to impair breathing about four minutes before there is any change in alertness and at 1,700-times lower drug concentrations than those that cause sedation. “This explains why fentanyl is so deadly: it stops people’s breathing before they even realize it.”

Stroke and your blood type

While people with type A blood are commonly considered witty, engaging, and smart, there is a downside: Having type A blood means you have a higher risk of stroke before age 60.

Doing a meta-analysis of 17,000 stroke patients, University of Maryland neurologists …

… found those who had blood type A had a 16 percent higher risk of having an early stroke than people with other blood types. Those who had blood type O had a 12 percent lower risk.

Why is this the case? They don’t know. “[I]t likely has something to do with blood-clotting factors like platelets and cells that line the blood vessels as well as other circulating proteins.”

And people with B or AB? They’re in the middle — just average.

Another anti-seizure drug (seems to) cause autism

Cutting to the chase: “[P]renatal exposure to topiramate roughly triples a child’s likelihood of having autism or intellectual disability.”

That’s what that UK’s equivalent to the FDA is investigating now, after a Norwegian/Australian/Icelandic/Finnish study found the connection. If true, it means topiramate joins another anti-seizure drug, valproate, that was already found to contribute to autism.

Then there’s this comment from a epidemiologist in Pennsylvania concerned about sharing this news:

“Hearing notice about this safety review may cause women to discontinue medication, and epilepsy itself is known to present risks to both the mother and fetus.”

Why yes, yes it might stop them from taking topiramate. But considering it’s based on a large, legit, peer-reviewed study published in JAMA, (not Cousin Tiffany’s Facebook post), doesn’t that make sense?