Handling the fluid shortage

Hospitals are finding new and interesting ways to deal with the IV fluid shortage caused by Hurricane Helene. (Baxter says its North Carolina plant is producing the fluid, but it’s far from full capacity.)

Something you might not think about: As the end of the year approaches, people are scheduling more surgeries to either use up benefits or to avoid a big hit when their deductibles reset in January. That puts an even bigger strain on IV supplies.

Using push medication — IV without the fluid — is one way (although it requires more monitoring). Another is to squeeze every last drop out of a bag before starting another; it adds up. And, of course, there’s simply cutting back on fluids:

Patients may be asked to take more accountability for their hydration, by drinking Gatorade or water rather than the default of hydrating through an IV.

Singulair side-effect update

When Merck launched Singulair (aka montelukast) in 1998, it claimed that the drug had side effects “similar to a sugar pill.” It turned out that wasn’t true (and Merck apparently knew it), and montelukast can have serious neurological effects; in 2020 the FDA added a black box warning to the drug “flagging serious mental health risks like suicidal thinking or actions.”

Now, four years later, the FDA expert group that looked into montelukast’s side effects found that yes, it binds to multiple brain receptors.

“[T]he new data showed significant quantities of montelukast present in the brain. The receptors involved play a role in governing mood, impulse control, cognition and sleep, among other functions.”

They still can’t say for sure that the binding causes those neurological effects, but as one scientist said, “It’s definitely doing something that’s concerning.”

Pertussis vax does more

A new vaccine for whooping cough has a couple of extra benefits. First, it’s nasal — no needles to worry about. Second (and this is the bigger part), it’s also got an “innovative adjuvant called T-vant, [that] boosts the body’s immune response specifically in the respiratory tract.”

So what? That means it not only protects the person getting the vaccine, but also reduces the likelihood of them spreading it to others. As the Tulane University immunologist leading the team put it:

“By developing a vaccine that can not only protect individuals but also prevent transmission, we hope to improve on existing vaccines and limit the spread of whooping cough in communities.”

Of course, with more people believing the nonsense from anti-vaxxers, it’ll fall on more-informed folks to do their part to stop the surge of pertussis.

A peptide for pain

Oxytocin does some interesting things in the body, among them inducing uterine contractions. But it can also treat abdominal pain. The problem is that it’s a peptide, and like most peptides it’s not gut stable; it has to be injected.

Aussie researchers, though, say they’ve found a way to make peptides gut stable, meaning oxytocin and derivatives could be made into pill form, and still have all the benefits of peptide-hood (e.g., few side effects).

The research indicates that the new molecules work in the colon and do not need to cross the gut barrier into the bloodstream to suppress abdominal pain.

Now they just need someone to pay for them to try to make it something they can sell.

Two quick health stats

Deaths from heart disease caused by obesity have gone up 280% from 1999 to 2020 — i.e., nearly tripled — according to research out of Brown University. “Middle-aged men, Black adults, Midwesterners, and rural residents are most at risk.”

—and—

More than 100,000 Americans under 20 have inflammatory bowel disease — that’s both Crohn’s disease and ulcerative colitis — according to a study out of UNC Chapel Hill. And since 2009 that number has gone up 22% (Crohn’s) and 29% (ulcerative colitis).

Elsewhere: Going nowhere

Remember all the hubbub Florida made about importing vaccines from Canada? The state even sued the feds for not moving fast enough. Well, Florida got the green light in January 2024, and since then … nothing.

A Florida health official familiar with the importation program told KFF Health News there was no planned date yet for the state to begin importing drugs.

Speculation was that the fuss wasn’t really about getting the drugs, but, as one analyst put it, “It riles up the crowd.” The reality has always been that it won’t happen because Canada won’t allow it, but that didn’t stop people from having a dream. So while there are lots of excuses, there’s no real plan in the works. Maybe just ‘concepts of a plan.’