A drug for sleep apnea?

CPAP, schmeepap — carbonic anhydrase inhibitors (e.g., sulthiame) can reduce the number of times someone with sleep apnea stops breathing during the night, thanks to the way carbonic anhydrase helps the body balance carbonic acid and carbon dioxide.

Swedish researchers found that…

Compared to before receiving the treatment, breathing pauses decreased with on average more than 20 per hour for patients given the drug.

And for 20 percent of the patients, “the number fell by at least 60 percent.” The best part is that, because these drugs are already approved for other uses, further testing will be quick.

The call of training

Luckily, GPhA is offering that very “APhA’s Pharmacy-Based Immunization Delivery: A Certificate Program for Pharmacists” in about a month: Sunday, May 22 from 8:00 am – 5:00 pm at GPhA’s World Headquarters in Sandy Springs. Time to register and prepare.

Note: This is always a popular course, so sign up quick so you are aren’t left out and embarrassed to show your face at the convention. Get to GPhA.org/immunization for the details and to register!

Severe Covid could get a med

Sabizabulin: Not just an 11th century Islamic mathematician, but also a new drug whose maker claims it cut deaths of seriously ill Covid patients in half.

If trials bear this out, it’s a big deal because there aren’t treatments for the critically ill. (Antivirals like Paxlovid keep people out of the hospital; they’re not helpful for the seriously sick.)

“Sabizabulin is the first drug to demonstrate a clinically and statistically meaningful reduction in deaths in hospitalized patients. This represents a big step forward.”

So says the CEO of the company that makes it, and kudos to him for not calling it a “game-changer.”

Speaking of antivirals….

A new one — a nasal spray — might be a better option than pills or an IV. Human trials are coming soon, but it works in mice, so that’s something. The best part isn’t just that it (seems to) work better than existing antivirals, but that it works on every Covid-19 variant.

By blocking the virus’ spike protein, the new antiviral prevents it from binding to the human [ACE2] receptor, which is the entry point for infecting the body. Because the novel coronavirus and its mutant variants cannot infect the body without binding to the ACE2 receptor, the antiviral also should work against future variants.

Where techs can cash in

Hey, pharmacy techs — wondering what city has the best pay? Wonder no more: In Georgia, it’s Hinesville*, with an average technician salary of $37,980. (Forbes has the full list for every state, from Ann Arbor and Billings to Topeka and Trenton.)

* Home of the ITPA National Telephone Museum

Old med, new anti-anxiety treatment?

Disulfiram, which is normally used to treat alcoholism, might also be a good anti-anxiety drug. Japanese researchers, wondering how it effect on chemokine receptors might affect stress level (after all, it is regulating emotions, in a sense) tested it on mice.

They found that mice treated with disulfiram were less anxious than the control group — in fact, the results were on par with diazepam, but without the side effects.

Their best guess is that disulfiram inhibits the FROUNT protein, and that may (through science) lead to lower levels of glutamate in the brain, reducing overall anxiety.

Just keep gouging, just keep gouging….

Just because your drug is more than 10 years old doesn’t mean you shouldn’t keep hiking the price — not when you’ve got that tasty, tasty Medicare trough to feed from.

Upon market entrance, Xarelto’s list price was $218 for a month’s supply, and Eliquis’ list price was $250.

As of January 2022, the list prices for a month’s supply of Xarelto and Eliquis are $516 and $529, respectively. Medicare Part D has spent more than $46 billion on the two drugs since 2015.

Rite-Aid continues wind-down

The company is expected to close 145 unprofitable stores this year, which includes 63 already on the chopping block. Even though its revenue was up in the fourth quarter (to just over $6 billion), Rite Aid still lost $389 million. Yikes.

But fear not. Said CEO Heyward Donigan*, “As we look forward to the year ahead, we are ready and energized to compete in a new post-pandemic normal.”

* Who received a $1.16 million bonus in 2021 as part of his $9.6 million package

Why 80ish?

Charmin the Hamster lives about three years; some whales live centuries. Humans tend to fizzle out around 80. But why?

It’s not size or metabolism after all. The answer may well be our somatic mutation rate.

Genomics researchers at Britain’s Wellcome Sanger Institute found that long-living animals are those “successfully slowing down their rate of DNA mutations regardless of their size.” Look at the numbers:

• Mice suffer about 800 mutations a year — lifespan: 3.7 years.
• Naked mole rats and giraffes accumulate about 93 and 99 mutations a year, respectively — lifespans: 24-25 years.
• Humans? We’re looking at 47 mutations a year.

No, the math isn’t perfect correlated, but lifespans vary. What they found is that the average number of mutations at the end of lifespan — no matter what the species — was around 3,200, suggesting that at some point there are simply too many errors for a body to compensate for.

How to boost a sunscreen

What ingredient could be added to sunscreens to make them even more effective? And better yet, be something that comes from nature, to appeal to today’s discerning consumers?

If you said “iron-trapping antioxidant molecules,” you win 500 Internet Points.

Pharmacology researchers at Britain’s University of Bath found that including natural antioxidants — especially those that can bind to the iron molecules produced by sunlight — can lead to significantly better sunscreens. And because those antioxidants are common in nature, it’s just a matter of finding the right ones.

“By including these potent antioxidants in skin-care products and sunscreen formulations, and therefore trapping free iron (not to be mistaken for bound or stored iron), we can expect to get an unprecedented level of protection from the sun.”

Iron armor it is, then

Lawmakers want naloxone OTC

They don’t have the power to make that happen, so they’re pressuring seven naloxone manufacturers to apply for OTC status “without delay.”

While many states have standing orders and workarounds that allow individuals to acquire naloxone without a prescription, regulatory hurdles continue to create unnecessary barriers. Further, a formal switch to OTC status will help reduce stigma and encourage the widespread use of this critical medication during emergencies.

Don’t forget: Spring Region Meetings are coming fast!

“Spring is here, spring is here, life is skittles and life is beer.”
—Tom Lehrer, “Poisoning Pigeons in the Park”

Spring is also the time for GPhA’s aptly named Spring Region Meetings, coming up later this month. It’s time to register for yours!

Not only do you get to hang with your fellow pharmacists for an evening (where the food is good but the price is low), the updates you’ll get count for an hour of CE. W00t!

And this year we’re back to separate meetings for each region — find yours, find your meeting, and register now!

HPV: Once and done

After a few years of collecting data, it seems that girls and young women only need one dose of HPV vaccine to provide protection against cervical cancer. The two-dose regimen has been standard, but now the WHO says girls under 21 can make do with just one shot, while women over 21 should continue to get two doses. (It does not say what 21-year-olds should do.)

You know ’em when you meet ’em

UGA researchers are asking the important questions.

(You can read the paper here.)

Hello old friend

It’s only April, but the writers are already teasing potential plot lines for next season. Researchers at La Jolla Institute for Immunology found that the Zika virus — which was a Pretty Big Deal a few years ago, especially in South America — “can mutate to become more infective — and potentially break through pre-existing immunity.”

The scary part about Zika is that it can be mild for a woman, but devastating for her unborn child — think infant microcephaly and other neurological problems.

The (sort of) good side is that it’s only transmitted either by mosquitoes or sexually, so protection is a bit easier. Unless it mutates.

Slightly interesting notes on arthritis drugs

When TNF inhibitors don’t work, the next step is often a JAK inhibitor — one with a cool name like Xeljanz*. But with safety concerns still looming, it seems rheumatologists are cooling on the drug class. The big winner: Bristol Myers Squibb and Orencia.

“Interestingly, preference for Bristol’s Orencia post-TNF use has been increasing at nearly the same rate that preference for the JAKs has been decreasing.” [T]wo-fifths of respondents selected Orencia as their “preferred agent to prescribe” when discontinuing a TNF agent.

But what about IL-6 inhibitors? Meh: “[Their] overall brand share ‘has remained flat’.”

* Not to be confused with Xilhanz the Conqueror

Today’s potential Alzheimer’s treatment is …

… niacin. The association between niacin and cognitive decline — or, rather, the lack of it — has been known for a while. But we’re smarter now and have much cooler tools to play with, so several studies are underway to tease out the connection, and hopefully take advantage of it.

Research findings published in the last few years have suggested that niacin can modulate the activity of microglia, important immune cells in the brain, in mice models for Parkinson’s, glioblastoma, and multiple sclerosis.

(It seems that niacin might prevent microglia from overreacting when they detect amyloid plaques (causing inflammation), while at the same time enhancing their good work, like removing debris. Time will tell.)

The Long Read: Ransomware edition

When big health systems or hospitals get hit with ransomware attacks it makes the news, but smaller companies are also in the crosshairs. (The bad guys don’t just target a specific company; they also sniff out anyone using compromised software — big or small.)

Thus, “At small and rural hospitals, ransomware attacks are causing unprecedented crises.”

Georgia’s cancer hotspots

There are four areas in Georgia that are hotspots for cancer — specifically breast, prostate, and colorectal. And the reasons aren’t clear.

An Augusta University researchers found that, from 1999 to 2019, cancer deaths in the state “were concentrated in the eastern Piedmont to the southern-most Coastal Plain regions, as well as the southwestern rural and northern-most rural areas.”

Each of these hotspots has a high percentage of Black residents, older residents, and/or poor residents — but not always all three. The largely rural region around Augusta, for example, has several clusters:

Elbert County for colorectal cancer in Black adults, Jefferson and Jenkins counties for colorectal cancer in white adults, and McDuffie and Wilkes counties for colorectal cancer in all adults. […]

Neighboring Warren County was a breast cancer hotspot for all women, a lung cancer hotspot for Black men and a colorectal hotspot for all adults.

What does it mean, why do they exist, and what can be done? All that comes next.

Don’t miss your chance

How convenient that GPhA is offering the ultra-popular “APhA’s Pharmacy-Based Immunization Delivery: A Certificate Program for Pharmacists” on Sunday, May 22. It’s from 8:00 am – 5:00 pm at GPhA’s World Headquarters in Sandy Springs — a great idea before the next pandemic wave hits.

Note: This is always a popular course, so sign up quick so you are aren’t left out and laughed at by all the cool kids. Get to GPhA.org/immunization for the details and to register.

Covid in 34 seconds

Cases have continued to rise nationwide, but not hospitalizations or deaths … yet. It’s (mostly) concentrated in the Northeast and Mid-Atlantic so far. A blip or another surge?

Mayo Clinic: Cases will jump 54.4% in the next week and a half.

CDC: Hospital admissions https://www.cdc.gov/coronavirus/2019-ncov/science/forecasting/hospitalizations-forecasts.html over the next month. Maybe. Deaths should decline. (Unless the Mayo guess estimate is right.)

Do you want field mice? Because this is how you get field mice.

By leaving your office building empty for two years … but leaving food behind. Bonus: It’s the FDA.

Marketers wonder who influences patients

Pharmaceutical makers want to market their products, but face-to-face meetings with physicians are harder in These Trying Times. So two researchers set out to learn who, besides physicians, might have “prescribing-type conversations” with patients

So two researchers set out to learn “who could be the other people who have prescribing-type conversations” during a patient’s “prescribing journey.”

They were surprised at what they found. Can you guess?

“Surprisingly, pharmacists, who we didn’t foresee as having the potential influence they probably do, emerged as a key segment because they’re at that retail kind of moment of truth. Affordability is an issue for a lot of Americans today.”

How did pharmacists influence patients? It’s all in this statement: “We’ve been hearing from some clients that callbacks are a phenomenon for brands where they no longer have exclusivity.” Translation: When a cheaper generic or alternative is available, pharmacists are helping their patients to switch.

Statins sooner: Penny spent, dollar earned

Instead of waiting for patients to have a high risk of cardiovascular disease from high LDL cholesterol, it makes more sense, financially, to start them on statins sooner.

Northwestern researchers did the math and figured that, especially in countries that start statins later (like Scotland), public or private payors spend less on the ounce of prevention — especially with most statins so cheap — than they would on the pound of cure, i.e., treating heart disease.

Same outcome, except for the death part

All cancers are different, but that doesn’t mean a drug for one won’t work on another. In this case it’s nintedanib, the lung cancer drug. It turns out (say British researchers) that adding it to the chemotherapy of patients with bladder cancer significantly improves their survival.

Further study is needed: Adding nintedanib increased survival, yes, but it didn’t improve the cancer overall (the “pathological complete response”). Why that’s the case will require more studies.

And today’s potential Covid treatment comes from…

… pumpkins and peas. The flavonoids they contain, Israeli researchers found, work really well with zinc supplements to stop the virus from infecting cells. (Not science-y enough? Fine. The polyphenolic flavonoids act as zinc ionophores and transport zinc cations through the cell membrane*. Better?)

Anyway.

The combination of supplements effectively inhibited the replication of the virus in several cell types, notably in human lung cells, the researchers found. More than that, the supplement combination they created was more effective than if a person had taken each component individually.

* They “established unique synergistic combinations based on zinc and polyphenolic flavonoid zinc ionophores to prevent Covid-19”.

Reversing hearing loss … with drugs

A small biotech company — Frequency Therapeutics — is testing a drug to reverse hearing loss. And by “testing” we mean “has already given it to more than 200 people as part of a trial.”

Injected into the ear, its small-molecule concoction ‘reprograms’ progenitor cells (kinda like stem cells) in the inner ear, which then regrow as the tiny hair cells that were damaged by loud noises or certain drugs — the tiny hairs we need to hear.

“Some of these people [in the trials] couldn’t hear for 30 years, and for the first time they said they could go into a crowded restaurant and hear what their children were saying.”

Drug discovery: Full speed ahead

Creating new drugs means testing millions of molecules to see if any do what you want. It can take a while, as you might imagine. But now those shifty Danes say they have a better, faster way, using (obviously) nanotechnology*.

Instead of using gigantic drops, these use nanoscale bubbles — so small that “More than 40,000 molecules can be synthesized and analyzed within an area smaller than a pinhead.”

That means a heck of a lot less material is needed, and the process is fast. Really fast. Like, a million times faster, they claim.

So, if you do the math, a drug that would have taken a year to discover could now take …

• One year = about 8,766 hours or 525,960 minutes.
• A million times faster would mean it would take 0.526 minutes — about 32 seconds.

* Plus “synthetic biochemistry […] DNA synthesis, combinational chemistry, and even machine learning.”

Supplement warning

If you sell — or, worse, take — SAMe (S-adenosylmethionine) as a supplement, you might want to stop.

Forget the claims on the bottle; British and Japanese biologists found that rather than do your body good, SAMe breaks down into adenine and methylthioadenosine, neither of which is particularly healthy.

“When we gave the supplement to mice we expected they would become healthier. But instead we found the opposite. We found that when SAMe breaks down in the body, it produces very toxic molecules, including adenine which causes gout, kidney disease and liver disease.”

They do note, though, that “SAM could potentially be used to correct circadian misalignments caused by shiftwork or jetlag.”

Covid, kids, and atopic dermatitis

The effects of Covid, the lockdowns, the masks … we’re still learning all the effects they’ve had. Here’s a new one: Irish kids born during the lockdown(s) were more likely to have atopic dermatitis.

• Kids born in 2008: 15.5% had atopic dermatitis in the first year.
• Kids born in early 2020: 25.3% had it in the first year. (They also tended to be more sensitive to eggs. Go figure.)

Lithium vs aging kidneys

Everyone’s favorite mood stabilizer might have some other uses. Specifically (and surprisingly), lithium may slow the aging of your kidneys.

Well, maybe not completely surprising, as the lithium/longevity link has been pondered for a while. But now University of Toledo researchers found that 1+1=2.

1: Turning off the gene that produces the GSK3-beta enzyme keeps kidneys from aging.

1: Lithium happens to target GSK3.

2: Giving mice lithium chloride lowered protein levels in urine and improved kidney function: “Our results very clearly showed low-dose lithium attenuates kidney aging in mice.”

A face full of aprotinin makes the Covid virus go down

If you want a Covid patient out of the hospital sooner, a spritz of aprotinin might do the trick.

Aprotinin is a protease inhibitor, and SARS-CoV-2 needs proteases for its spike protein to bind to cells. Ergo, inhibit the protease and you inhibit the virus. The Germans discovered this, and now the Spanish have confirmed that it works in the real world.

[A] Spanish research consortium has published the findings of a phase III clinical study investigating the use of an aprotinin aerosol in COVID-19 patients. Among other improvements, aprotinin treatment reduced the length of hospital stays by five days.

Apparently you have to be topless to use a spray bottle

How do you do, fellow kids?

Solving a problem we didn’t know we had, psychologists at Penn State (and one from the University of Washington to keep them in line) have developed a new way for young folks to describe the effects of alcohol and marijuana.

Gone (they hope) would be the 1-to-100 scale of “How drunk/high do you feel?” which, they said…

… might not adequately differentiate between various levels of effects and might not be in line with the common language used among young adults.

Instead, they crowdsourced that question to learn the words Today’s Kids use. The result: a new, more-accurate replacement with a mere four options: relaxed, calm/chill, high, and stoned/baked.

He who hesitates…

Two interesting studies on vaccine hesitancy.

One, out of New Zealand and Duke University, found that…

… many vaccine-resistant adults had histories of adverse experiences during childhood, including abuse, maltreatment, deprivation or neglect, or having an alcoholic parent.

This, they think, might have “contributed to a lifelong legacy of mistrust in authorities.”

The other, from the University of South Alabama, found something surprising. Sure, being psychotic or narcissistic was “related to more anti-vaccination perceptions and behaviors” — no surprise there. But it also found that conscientiousness was correlated with anti-vax views. Why would “the tendency to be organized and exhibit self-discipline” lead someone to eschew a life-saving shot?

“Conscientious people may believe that they can compensate for vaccinations via other health behaviors (e.g., social distancing), but further research is needed to explore this surprising finding.”

Up practice-scope

The president of the Pacific Research Institute argues in Forbes that it’s time to expand the scope of practice of “physician assistants, nurse practitioners, and other qualified professionals”. It worked during the pandemic, freeing up physicians and helping more patients.

The same will be true after the public health crisis ends. Permanently rolling back restrictive scope-of-practice laws—and letting experienced healthcare workers do their jobs—is a common-sense reform that could benefit patients and the healthcare system alike.

PAs and NPs … it seems other health professionals might have been left off her list. Any ideas?

The Long Read: Curbside Pickup edition

Curbside pickup is great for customers who don’t want to venture into the depths of your pharmacy. One problem: They don’t get to impulse buy the way you want. When Junior can’t grab the Snickers at eye level by the register, what’s a pharmacy owner to do?

Drug Store News has some answers to help “Get them to crave candy.”

“Eye level is buy level”

UGA’s got a faster Covid test

Covid tests: They can be fast or they can be accurate. You choose.

Unless, that is, you use the the new test developed by UGA scientists (including an engineer, two physicists, and an infectious disease specialist).

As you probably guessed, it uses a localized surface plasmon resonance virus sensor that they developed — it’s based on human ACE-2 functionalized silver nanotriangle arrays. Naturally.

The point is, it’s faster than even a rapid test, but it’s much more accurate — and it can be used on any existing Covid-19 variant. They hope to package it as a $10 device that connects to a smartphone.

Hey, folks from Mercer, PCOM, and South: Wondering why all the UGA news? The folks there send it to me! I would love love love to write about happening at your schools. Please take a minute to add andrew@gphabuzz.com to your press lists, and we can make that happen!

True, but misleading

“US life expectancy continues historic decline with another drop in 2021” is the headline. And it’s probably true — thank you, Covid.

And while it’s accurate (and awful), it’s also a blip on a line; it’s what happens when 980,000 Americans die unexpectedly in two years. But it doesn’t mean that suddenly everyone will a die a year or two early. These are averages.

It’s like saying “People in the Middle Ages only lived to 35.” No. That was an average thanks to lots of infant deaths. They lived into their 70s and 80s. Ditto today: A lot of lives were cut short, but overall we’re still likely to live just as long.

So no, don’t sell your Hallmark stock because you think sales of “Happy 80th Birthday!” cards are about to collapse.

Say what?

Here’s an interesting tidbit for the virtual water cooler: Smoking tobacco is associated with hearing loss, but not smoking marijuana.

The study’s authors, out of the universities of Colorado and Mississippi, did note that “However, sole use of cannabis was relatively rare” so you have to be careful about drawing conclusions.

APhA’s hot hot hot immunization program is coming up

Sign up for “APhA’s Pharmacy-Based Immunization Delivery: A Certificate Program for Pharmacists” on Sunday, May 22. It’s from 8:00 am – 5:00 pm at GPhA’s World Headquarters in Sandy Springs.

Note: This is always a popular course, so the sooner you sign up the lower your chance of being left out and laughed at behind your back.

Get to GPhA.org/immunization for the details and to register. Now!

The kisspeptin of life

You might think of kisspeptin as one of those hormones involved in puberty and reproduction — or maybe “that hormone named after Hershey’s Kisses.” And you’d be right.

But get this: Kisspeptin might also protect people from non-alcoholic fatty liver disease. Kisspeptin (Rutgers researchers found, binds to a protein in the liver called KISS1R, and it prevented mice on a Western diet from developing NAFLD, including steatohepatitis and fibrosis.

So now the trick will be turning this discovery — the kisspeptin receptor signaling pathway — into an actual therapy for fatty liver.

Smell you … sooner?

Loss of smell is one of the hallmarks of Covid-19, and one of the most annoying. But there may be help in the form of camostat mesylate, the med usually used to treat pancreatitis.

It was already being looked at as a treatment for Covid (along with every other drug on the planet). No joy. But a Yale team testing it found that, while it didn’t affect the Covid viral load, it did give some Covid sufferers their sense of smell back.

That was enough for Yale to pull out everyone’s favorite descriptor: “If the drug were to be approved for this purpose, the doctors believe it could be a game-changer.”

ICYMI: Aduhelm’s out (mostly)

Medicare finalized its decision — it won’t cover Biogen’s super-expensive (and mostly ineffective) Alzheimer’s drug, Aduhelm, except for patients in clinical trials. But it did say it would cover certain unapproved drugs that demonstrate a clinical benefit … in certain cases.

Good news: Medicare had raised its premiums, expecting to have to pay for Aduhelm. Now it may lower them.

Elsewhere: California’s oopsie

Public-private partnerships — hiring a private company to do public work — can be great. Unless, perhaps, the private company you hire gets bought by one you wouldn’t have hired. “California Handed Its Medicaid Drug Program to One Company. Then Came a Corporate Takeover.”

The Long Read: Cancer Vaccines edition

Not long ago, the idea of a vaccine against cancer would have seemed ludicrous. Now, not so much — think HPV. But that’s the tip of the iceberg. Check out “New generation of cancer-preventing vaccines could wipe out tumors before they form.” Spoiler: They’re not just in the lab; human trials are happening.

It already tastes like medicine

You might think that licorice has no real use other than as a Halloween punishment for trick-or-treating hooligans. But that might not be the case.

A chemical found in the licorice plant, glycyrrhizin (also a winning Scrabble word), might have anti-inflammatory and anti-cancer properties — at least according to researchers at the University of Illinois. It’s not out of thin air; the idea is based on their review of existing, if sparse, research into glycyrrhizin.

Their paper also tied for 3rd place in the 2022 Most Science-y Title contest: “Oncopreventive and oncotherapeutic potential of licorice triterpenoid compound glycyrrhizin and its derivatives: Molecular insights.”

We would never make a joke about going blind

… but we will point out that a large study out of Canada found this:

The risk of developing one of three serious eye conditions increases by 85 per cent for regular users of common erectile dysfunction (ED) medications such as Viagra, Cialis, Levitra. and Stendra.

16 shades of sleepiness

A patient comes to you with trouble sleeping. Maybe you say “Benadryl, second aisle on the left,” or maybe you dig a bit deeper — find out what kind of sleeper they are. In fact, you might think there are two categories: night owls and morning people.

In fact, there are as many as 16 distinct types of sleepers/sleeping — at least, if you believe the Japanese biologists who studied the data of more than 130,000 people.

Those types are based on how long you sleep, how long you’re awake, what the sleep/wake pattern is, and more, and include “2b. Fragmented sleep with short sleep duration” and “4b-5. Insomnia with normal sleep duration and long-term midawake with less fragmented sleep.” There’s even a category for the worst people of all: “4b-2. Morning person.”

More insomnia woes

Insomnia doesn’t just make you grouchy. Apparently it raises your blood sugar levels and increases your risk of diabetes. So report a team of (mostly) British researchers in the American Diabetes Association’s journal Diabetes Care.

“We know from past research that there’s a link between sleep and a person’s risk of type 2 diabetes, but it hasn’t been clear which comes first, bad sleep or higher blood sugars, or if other factors are at play.”

(Yet another reason to get your sleep. In February we reported that insomnia increases your risk for flu and Covid-19, too.)

Out, damned DOX!

The obvious downside to chemotherapy is that the drugs are so darned strong, they Hulk-smash their way through healthy and cancerous cells alike.

One way around the issue involves better targeting of the drugs. But there’s a concurrent option: keeping those drugs from staying in the body longer than they need to.

Engineers at the Medical University of South Carolina have “developed a device to remove excess chemotherapeutic drugs from circulation after cancer treatment.” They focused on doxorubicin for now, and were able to remove 30 percent of it in about an hour.

DOX is sent into the body by encasing it in heat-sensitive nanoparticles. Heating the tumor causes the particles to break down and release their payload there. Problem: Eventually, the rest of the nanoparticles dissolve in the body and dump the DOX willy-nilly.

The MUSC team’s system takes advantage of that heat sensitivity by taking the patient’s blood, heating it to release the meds, filtering them out, and returning the blood — like an artificial kidney just for DOX.

Reducing the exposure of patients to leftover chemotherapy drugs could allow them to recover faster, with fewer side effects. It could also enable them to receive more chemotherapy cycles in the future in case additional treatment is necessary to kill the cancer cells.

Kids today, cardiovascular patients tomorrow

Just a handful of factors in kids is all it takes to predict their chances of having serious cardiovascular issues down the road.

Keep an eye on these five things, say an international group of researchers (led by the University of Minnesota Medical School): high BMI, high blood pressure, high cholesterol, high triglycerides, and youth smoking.

Those with the most boxes ticked can have up to nine times (nine times!) the risk for stroke, heart attack, or death, from as early as 40 years of age.

Congrats to UGA College of Pharmacy’s Class of 2023!

Here they are, looking so fresh — wide-eyed and naïve — at their pinning ceremony on April 1. Make a toast, if you would, to their last shred of innocence before venturing out into the cruel, cruel world.

Why you pharm

What’s the real reason you spent all those years in school — and (for many of you) took on all that debt? Sure, the official line is “Because I love chemistry and want to help people be healthy,” but a pair of psychology researchers (one Italian, one British) have unearthed the truth:

“Being More Educated and Earning More Increases Romantic Interest: Data from 1.8M Online Daters from 24 Nations”.

In every nation, a person’s resource-acquisition ability was positively associated with the amount of attention they received from other [online dating] site members.

Money quote, soon to be on a dishtowel: “Mating mistakes have both reproductive and psychosocial outcomes.”

Side note: Oyster contamination

If you know anyone who, for reasons I cannot fathom, eats oysters — well, tell them to avoid any from British Columbia. The FDA is warning about contamination with norovirus in oysters shipped all over the country. (Georgia isn’t listed as a destination, but Florida is, and “It is possible that additional states received these oysters through further distribution.”)

How can you tell they’re from BC? Consumers probably can’t, so maybe just avoid oysters for a while.

Shouldn’t be too hard.

g

When bacteria eat ACE inhibitors

ACE inhibitors don’t always work as well as you’d like against hypertension, and now microbiologists at ath University of Toledo might have figured out why. All together: “Oh, sheesh, gut bacteria again?”

Apparently the Coprococcus comes bacteria is the problem — or at least the biggest problem discovered so far. Simply put, C. comes produces enzymes that break down at at least one ACE inhibitor: quinapril.

Of course, different people have different gut biomes, so “the same drug may not be appropriate for everyone because each person has a unique gut microbial composition with a unique profile of enzymatic activities.”

Congrats to Wellstar!

Wellstar Health System received the Healthcare Information and Management Systems Society’s Stage 7 ranking — the highest available — in two categories for its use of data analytics and medical-records technology. Fewer than 10 percent of U.S. hospitals achieve Stage 7 status; Wellstar is the only health system in Georgia to nab it.

Covid comeback?

In general, Covid-19 cases in the U.S. are continuing to drop, although the drop is leveling off. (Cases in Georgia are actually up by 8 percent over the last two weeks.) Meanwhile, Europe is seeing a serious resurgence. So why is America not seeing the same bump?

It could be…

• … because in ‘pro-vaccine’ areas, well, people are vaccinated; in anti-vaccine areas, they’ve either been infected or they’re among the country’s 981,000 dead*.
• … because people are losing health insurance and can’t afford testing, or they’re doing testing at home and not reporting results.
• … because states are under-reporting positive results.
• … because the right butterfly flapped its wings at the right time — as University of Minnesota epidemiologist Michael Osterholm put it, “I don’t know, and I don’t think anybody really knows.”

Or maybe our surge is still coming down the pike.

* Money quote on the issue: “Most of Europe has been pretty Covid-averse, you know, whereas parts of the United States have been quite Covid-curious.” —Harvard epidemiologist Bill Hanage

Students and recent grads — you heard this, right?

“White House extends student loan repayment freeze through August”

What’s new?

New mRNA vaccines that don’t require the serious refrigeration that Moderna’s and Pfizer’s do. One from China’s Walvax Biotechnology is in phase 3 trials; another from French-Thai company BioNet-Asia is about to begin.

A new body part — specifically, “a brand-new type of cell hiding inside the delicate, branching passageways of human lungs.” Dubbed respiratory airway secretory (RAS) cells they’re kind of like stem-cells lite, “capable of repairing damaged alveoli cells and transforming into new ones.”

Everything is Covid

The Brits have officially added nine new signs of infection to the list of Covid-19 symptoms, to the point that just about everything is a Covid symptom. An exaggeration? Nope. On the new list are “feeling sick or being sick.”

Vibrating the diabetes away

Are you planning to keep treating diabetes with drugs and lifestyle choices? How quaint!

Coming soon, courtesy of a group of biomedical engineers: treating it with ultrasound. How? By stimulating the liver’s porta hepatis — an area that “communicates information on glucose and nutrient status to the brain.”

[S]hort targeted bursts of pFUS at this area of the liver successfully reversed the onset of hyperglycaemia. The treatment was found to be effective in three separate animal models of diabetes: mice, rats, and pigs.

So, does that mean people would need to carry an ultrasound, er, thingamajig with them 24/7? Nope. “[J]ust three minutes of focused ultrasound each day was enough to maintain normal blood glucose levels in the diabetic animals.”

ICYMI

There’s a new variant out there — Omicron XE. But not to worry. Apparently we’ve already been through Omicron XA to XD and no one bothered to mention it. This is just the first time they’ve told us not to worry….

Publish, perish … or pay for peddled placement?

Let’s say you want your name on a few more papers, but don’t actually want to do any work. Apparently, a Russian company will pay off the real authors of papers to add your name to the list — even as corresponding author, in some cases. A German sociologist has been tracking the site since 2019 for her own paper.

More than 100 of these identified papers were published in 68 journals run by established publishers, including Elsevier, Oxford University Press, Springer Nature, Taylor & Francis, Wolters Kluwer, and Wiley-Blackwell, although most of these were specialized publications.

If you’re thinking of spending a few hundred bucks or more, there are at least two problems. First, it’s bleeping unethical. Second, thanks to sanctions, it’s illegal to do business with the Russians anyway.

For 70,000 rubles (about $834), you can be an author of a paper on modern antidepressants — hurry, the deadline is April 14.

Computers vs cancer

Cancer therapy can be notoriously hit-and-miss — you can’t always know what drug will affect which tumor. Now British researchers have sicced artificial intelligence on the problem and come up with “a prototype test that they think could be used to predict which combinations are likely to work in cancer patients within two days.”

Using a sample taken from a tumor, the AI can suggest which drugs or drug combinations are likely to have an effect. But unlike boring ol’ genetic analysis, this technique adds protein analysis to the mix, making it more accurate.

For example, it suggested dual therapy with Roche’s BRAF inhibitor Zelboraf (vemurafenib) and AstraZeneca’s experimental AKT inhibitor capivasertib be effective against NSCLC cell lines with no mutations in EGFR or KRAS.

When Snoop Dogg visits the pharmacy

Imagine he’s not just picking up some Corona or Tostitos, but also has some meds waiting. Now there’s a new tool you’ll want to check out first.

Penn State’s new CANN-DIR Web-based app — that’s “CANNabinoid Drug Interaction Review” — will warn you of potential interactions between cannabinoids (THC & CBD) and “concomitantly prescribed medications.”

It lets you select the type of cannabinoid, then choose any other drugs the patient is taking to give you any applicable warnings.

Today’s hot new potential Covid treatment

The latest Covid drug is both a preventative and a treatment! It’s a “newly discovered small molecule” that Cornell microbiologists named “N-0385” and put into a nasal spray. Using very, very steady hands, they tested the spray on mice.

N-0385 was shown to protect mice from infection prior to exposure, while also providing effective treatment when administered up to 12 hours after exposure.

It works on all Covid-19 strains through Delta, but they’re confident it’ll work against Omicron, too. They’re hoping they can raise money for human trials soon, and even fantasize about getting FDA emergency-use approval within six months.

Keeping prostate cancer at bay

Austrian pathologists have figured out why some (about 20% of) prostate cancers metastasize, turning a usually-curable condition into a deadly one.

It’s all about a regular protein called KMT2C. When it’s mutated by the cancer, it turns in its badge and gun and stops doing its job; the cancer spreads.

Good news:

KMT2C mutation status can be measured via a blood test, allowing early diagnosis of potentially aggressive progression in prostate cancers.

Even better, new drugs — MYC inhibitors — might be able to pick up the slack.

Violet Beauregarde would approve

If you have wounded rats, a extract from wild blueberries can help them heal faster. That’s what clinical nutritionists at the University of Maine discovered after testing a topical gel containing a wild blueberry phenolic extract.

Compared to animals that were treated with a base gel that did not contain the phenolic extract and a control group that received no treatment, the treated group showed improved migration of endothelial cells to the wound site and a 12% increase in wound closure.

Today’s odd non-pharma story

Science marches on: An international group of researchers, led by a Swede and publishing in Cell’s Current Biology, reports that all cultures share a common taste in odors.

Individuals might have different preferences, but in general, whether you’re in America or Africa or Asia, vanilla gets a thumbs-up. (So does ethyl butyrate — aka pineapple/fruit.)

And what does everyone hate? Isovaleric acid — “a cheesy or sweaty smell.”

Bacteria vs acne

The usual way to treat acne (pharmacologically, at least) is with antibiotics — kill the Cutibacterium acnes and get a prom date.

But with antibiotic resistance a problem, Belgian biomedical engineers came up with another solution: bacteria to fight bacteria. Specifically, using lactobacillus to fight both C. acnes and Staphylococcus aureus.

Fun fact: Not only does it work, it keeps working after treatment stops.

Fentanyl rising

When it comes to opioids, fentanyl is just about in a league of its own, it’s so powerful. And it’s cheap to make. Thus it’s ending up in other street drugs as sort of a deadly filler. In Georgia, state health officials said, there’s been a surge of overdoses — an average of more than one a day in the state attributed just to fentanyl added to other drugs.

“In the crime lab alone, the lab has seen an 80% increase of fentanyl results in the last year. We’ve also seen a disturbing trend of samples called ‘purple heroin/purp’ that contains heroin and fentanyl.”

And it’s not just here. An NYU study found that “Seizures of pills containing fentanyl increased 834% between 2018-2021.”

Drug factory in your gut

What if instead of simply tweaking gut bacteria to do no harm, we could introduce bacteria that would produce a drug? For example, L-DOPA for Parkinson’s?

That, in fact, is exactly what pharmacologists from UGA (and Iowa State) did by engineering a version of E. Coli to eat tyrosine and, um, expel L-DOPA.

It’s still just in the lab and just in mice, but a couple of interesting notes. First, the bacteria can just keep on keepin’ on, so there’s less risk of dyskinesias (a side effect probably caused by the L-DOPA slacking off). And second, they say they can control the amount of L-DOPA released by regulating either the E. Coli or its food.

Next up: “[O]ptimizing the engineered bacteria as the research looks to human trials.”

Drug to watch #1: Vupanorsen

Vupanorsen is still investigational, but the latest investigation found that yep, it lowers non-HDL cholesterol quite well.

It was designed to target ANGPTL3 proteins, and that it does — lowering levels by 95 percent. It also lowered triglycerides by up to 57 percent. In fact, the only bad stuff it didn’t affect was LDL cholesterol.

One caveat: These studies were done on patients who were also taking statins.

Listen to your medicine

Non-chemical drugs aren’t new — there’s transcranial magnetic stimulation (done in hospital) and transcranial direct current stimulation (which can be done with a homemade device). But those require either a medical professional or an ability to building an electronic devices based on a schematic you find online.

What’s catching on is a different kind of ‘digital drug’ — binaural beats, which are based on sound. The idea is that playing tones of different frequencies in each ear causes the brain to perceive it as a thir frequency, “thought to produce a range of effects, including relaxation and attentiveness.”

What’s crazy is that studies have shown it actually works … at least for reducing pain and stress. (Not so much for attention issues.)

Just consider the side effects

Older women should consider eating six to 12 prunes a day to prevent osteoporosis — all those prunes “may reduce pro-inflammatory mediators that may contribute to bone loss in postmenopausal women” according to a study out of Penn State.

“Prunes might be a promising nutritional intervention to prevent the rise in inflammatory mediators often observed as part of the aging process.”

Drug to watch #2: Patiromer

If you’ve got patients taking an RAASi for heart failure, adding patiromer might be an option. A study out of the University of Mississippi found that patiromer worked well to lower patients’ potassium levels — heading off hyperkalemia, a common side effect of RAASi.

“Here, what we show is that we can simultaneously get all three things — you can maintain normal kalemia, you can reduce the risk of hyperkalemic events, and you can improve RAAS inhibitor therapy, in patients in the longer term.”

Can you overdo boosters?

With Omicron BA.2 threatening to start another pandemic wave, more booster shots have been authorized for some folks. But how long can we keep this up? Not forever, say the experts — we’re gonna need a better vaccine.

Such a long-lasting pan-coronavirus vaccine “is a realistic hope” […] Several efforts are underway to create a universal vaccine—which would target parts of the virus crucial to its function and don’t change across variants—including an initiative by the U.S. Army.

In the meantime, there’s a 61-year-old gentleman in Germany — a place known to occasionally take things to excess — who got himself vaccinated against Covid-19 at least 87 times.

No, he wasn’t paranoid; he was selling the vaccination cards he received to anti-vaxxers.

Captain Obvious nods vigorously in approval

If you give middle-aged rats a lot of caffeine — the human equivalent of about six mugs of coffee (880mg) at once— they may develop arrhythmias. That’s the groundbreaking research out of the New York Institute of Technology.

‘Pulsing’ prednisone

If you’ve got some fat mice and someone suggested giving them prednisone, you’d (rightly) decline — daily prednisone can cause obesity (or make it worse), along with elevated blood sugar.

But what if you gave it to them weekly? That turns out to have the opposite effect, according to Northwestern geneticists.

Obese mice that were fed a high-fat diet and that received prednisone one time per week had improved exercise endurance, got stronger, increased their lean body mass and lost weight.

For reasons they’re still teasing out, “once-weekly prednisone promoted nutrient uptake into the muscles, and the mice also had increased muscle metabolism.”

Next up: Trying to determine the specifics of dosing, and figuring out why it works the way it does.

Bad metaphors, but a great reason to give

As March Madness gives way to the Final Four, the Georgia Pharmacy Foundation is betting on Georgia’s student pharmacists!

The word of the day: Alley-oop [ ăl″ē-oo͞p′ ]
A play in which a player throws the ball high towards the basket and their teammate jumps up, catches the ball, and slams it through the hoop.

Those student pharmacists have done the alley part. We need you to do the oop — support the Foundation 100 today!

All donations go directly to fund student scholarships at Georgia’s four pharmacy schools. Won’t you assist?

The price of dementia

The story: “Half of older adults now die with a dementia diagnosis, up sharply”

The rather important detail:

The biggest jump in the percentage of people dying with a dementia diagnosis happened around the time Medicare allowed hospitals, hospices and doctors’ offices to list more diagnoses on their requests for payment.

Not to mention…

[A]round this same time, the National Plan to Address Alzheimer’s Disease also went into effect, with a focus on public awareness, quality of care, and more support for patients and their caregivers.

Perchance to dream … of your own pharmacy

Some of us have the floating-but-sort-of-flying dream. Others dream they’re late for a high school math exam, or that they’re successfully involved in a land war in Asia.

But what if you dream about pharmacy ownership? Or what if you already own a pharmacy but want to crank it up to 11?

NCPA is here for you with the NCPA Innovation Center’s Pharmacy Ownership Workshop (sponsored by McKesson) — coming to Atlanta April 9 and 10!

More than 2,500 pharmacists have already attended the workshop — they know the secret handshake and what it takes to run a successful pharmacy. So wake up and start making your dream a reality (unless it’s that math-exam one).

Click here to sign up, then learn why attendees have called it “a must” and “the highest ROI you can get” in understanding what ownership takes.

You lookin’ at me?

Guys, here’s another reason to keep your blood pressure under control. You might think the world is out to get you. Sort of.

Apparently (say German researchers), not only are you more likely to notice angry expressions in others, but doing so can raise your blood pressure over time. It’s a vicious cycle that can’t end well.

“Hypertensive men recognized anger more often than any other emotion. So they overrated anger displayed in other people’s faces as compared to our healthy control group.”

With pioglitazone, less is more

Pioglitazone has ups and downs for treating type 2 diabetes. It can reduce insulin resistance, sure, but at typical doses it has some unwanted side effects.

But what if you used a lower dose? Say, just 15mg? According to a biomedical researcher and physician at the University of Buffalo, it works just fine — and without those side effects.

[H]e has been prescribing pioglitazone over the past decade at a low dose of 15 milligrams with excellent results of glycemic control without the side effects of weight gain and edema.

Captain Obvious just doesn’t inhale

“As Covid-19 cases fall and masks come off, flu cases are rising”

Admit it just doesn’t work

When pseudoephedrine went behind the counter, drug makers came up with an alternative for people who didn’t feel like asking for it: phenylephrine.

But as far back as 2006, we knew phenylephrine didn’t work. It just had kind of a similar name, and it didn’t hurt. But it did nothing.

There’s a word for that, and in 2015, pharmacotherapy researchers at the University of Florida’s College of Pharmacy called it like it is: “Over-the-Counter Oral Phenylephrine: A Placebo for Nasal Congestion” — they even called on the FDA to take it off the market.

“Scientific evidence continues to show that the most popular products on the market containing phenylephrine are ineffective. Patients who seek an over-the-counter remedy should get what they pay for: an effective and safe alternative to a prescription drug.”

That was seven years ago. It’s still on the market, prompting the authors of that 2015 paper to write a new editorial, “Why Is Oral Phenylephrine on the Market After Compelling Evidence of Its Ineffectiveness as a Decongestant?” (Most of the paper is behind a paywall, unfortunately.)

Secondhand bong

No, a contact high isn’t the biggest danger from hanging out with someone (not you, of course) using a bong. It’s the air pollution — it’s worse that cigarette smoke according to a study out of UC Berkeley. [Insert joke here.]

Particulates from cannabis bong smoking “were at least four times greater than concentrations from secondhand tobacco smoke from cigarettes or hookah.”

The researchers also confirmed what anyone with a pot-smoking friend knows: The air takes a long time to clear.

In one session, levels remained at more than 10 times the original concentration 12 hours after the group stopped smoking. This suggests people entering a home hours after a bong session could still be affected by secondhand smoke.”