Paxlovid reactions

If you’ve got a patient who takes Paxlovid after testing positive for Covid, keep a metaphorical eye on ’em. A lot of folks who take it are taking other meds and there’s a decent chance of a drug-drug interaction.

The median number of concurrent medications was seven. Researchers found that 70% had at least one DDI, which increased to 82% in patients ages 70 and older. Most DDIs required clinical intervention, with most needing assistance from a pharmacist.

Note those last two sentences — if there’s an interaction, it’s probably not a minor one.

The most common drugs that interact, say the Canadian researchers who did the study, are “cardiovascular drugs and those for benign prostatic hyperplasia, followed by central nervous system drugs and oral antithrombotic agents.”

Yet another reason you don’t want Covid

Sure, chances are low that a Covid infection will be a big deal, but it comes with a lot of baggage. A new one to consider: Guillain-Barré syndrome.

Based on data for more than 3 million people over 18 months, the Israeli study found that contracting Covid increases your risk of GBS in the six weeks after infection. (Being vaccinated with an mRNA shot reduces that risk.)

The bad news: “[P]eople with a recent Covid infection were six times more likely to develop Guillain-Barré than those without a recent infection.”

The reality check: GBS is really, really rare, so while a 600% risk increase sounds scary, the actual numbers are still pretty small. (Also, the data show an association not a cause.)

From our friends at UGA’s College o’ Pharmacy

NOMINATE A PHARMDAWG TODAY! Do you know a PharmDawg alumnus* who deserves special recognition? The College of Pharmacy is seeking nominations for the 2023 Distinguished Alumnus, Distinguished Service, and Outstanding New Alumni Awards. Click the links below to learn more about the criteria for each award. All nominations should be submitted by Sunday, October 29, 2023.

* We assume you can also nominate an alumna. Or an … alumnex?

The new Flu Index is here! The new Flu Index is here!

So far it’s a lot lower than last year, but a bunch higher than late October before the pandemic. Take from that what you will. (Georgia has the 17th highest level of flu, and the South in general is seeing higher numbers.)

Georgia Medicaid’s slow start

Georgia Pathways, Georgia’s ‘work for Medicaid’ program, is off to a bumpy start, per the Atlanta Journal-Constitution. The plan is expected to cover about 90,000 poor adults within two years, but so far “has enrolled just 1,343 in the three months since it was opened, the state Department of Community Health reported.”

Georgia’s program is an experiment; of the 10 remaining non-Medicaid-expansion states, Georgia is the only one given permission to try this kind of enrollment, which “limits coverage to people who can prove they work 80 hours a month or perform other specified activities.”

Remember: If a new program doesn’t succeed immediately, it’s a complete and total failure and has to be scrapped*. To hit the state’s projection of 90,000 enrollees by 2025 would mean enrolling about 11,250 people every three months. So we’re behind at the moment. Maybe give it more than 90 days?

* That is sarcasm.

Obesity mastermind

What’s the biggest driver of obesity? It depends on the diet program you ask. Maybe it’s sugars. Maybe it’s fats. Maybe it’s simply calories.

The answer, say University of Colorado researchers, is all three — but behind them all, like a criminal mastermind, is fructose.

In broad strokes, fructose prevents the body from using its fat stores for energy (it “triggers our metabolism to go into low power mode”) causing us to eat more to get energy, but also to keep those fat deposits growing. We become, they say, like hibernating bears, but instead of eating a lot and storing fat just for the winter, we’re doing it every day.

As always, they say, more research is needed.