A little sip’ll do ya

It’s time again to spin the Wheel of Conflicting Studies to answer (yet again) “Is moderate drinking good or bad for you?”

Today’s answer … it’s good for you!

Apparently (say British and Australian epidemiologists) light to moderate drinking is “cardio-protective” for those with heart disease — although they also mention that’s it’s supposed to be good for healthy people, too.

But the benefit comes from the “light” end of that spectrum — just eight measly grams. (The average U.S. drink has about 14g.)

People who averaged 8 grams per day had a 27% lower risk of death from heart attack, stroke or angina, compared with those who did not drink. Those who drank 7 grams per day had a 21% lower risk of death due to any cause.

Worth every penny

Remember “pharma bro” Martin Shkreli, (former head of Turing Pharma, who raised the price of generic Daraprim by 5,000%)? He’s in prison for securities fraud, and he owed a $7.4 million fine for defrauding investors.

We say “owed” — past tense — because Shkreli’s fine was paid off from (get this) the sale of his one-of-a-kind Wu-Tang Clan album “Once Upon a Time in Shaolin.” (Only a single copy was ever produced, and Shkreli bought it at auction for $2 million in 2015.)

Turning to pharmacies

If you noticed more people coming to your pharmacy for “health and wellness services” in 2021, you’re not alone. a J.D. Power survey found that the number of people turning to pharmacies for vaccinations and routine screenings.

• 2019: About 43 percent of people did so
• 2020: 48 percent of people
• 2021: 51 percent of people

Even better:

Customers who use at least one health and wellness-oriented service provided by their pharmacy each spend an average of $5 more than those who do not use these services.

Third time the charm

Pfizer claims its data show that a third dose of its Covid vaccine provides a ton of extra protection against the Delta variant:

[The data] suggest that antibody levels against the Delta variant in people ages 18 to 55 who receive a third dose of vaccine are greater than five-fold than following a second dose.

And it’s an even bigger boost for people over 65.

One size fits every guy

Here’s something to note: Although about 70 percent of healthcare workers are women, most PPE is designed for men, with our freakishly large faces and hands. (And that doesn’t take into account going to the bathroom when you’re wearing a HAZMAT suit.)

[R]espiratory equipment “poorly fit” 16.7% of female health workers compared to 7.6% of men. PPE — including gloves, goggles, face masks, visors, or protective suits — that doesn’t fit properly leaves users exposed to harmful substances or chemicals as well as infections.

Not a lot of people think about that, but Women in Global Health certainly has, and you can expect to hear more about it.

Three quick congrats

To doctors Deborah Elder, Eileen Kennedy, and Jason Zastre, all of whom were named to the leadership team of UGA’s Pharmaceutical and Biomedical Sciences Department.

Iron, man

So you want to make a reversible male contraceptive. You figure you’ll use heat to do it. Obviously nanoparticles will come into play (this being 2021), but your first attempt, using rust (sorry, iron oxide) is, well, suboptimal. Sure, you can guide them into place with magnets, but…

The injection can be painful, the heating can damage skin, and most nanomaterials tested so far are not biodegradable.

Second attempt: Coat the particles with polyethylene glycol! These sure get hot, but the magnets don’t work to put them in the right place. Ouch.

Third attempt: Coat them with citric acid. Lo and behold, it works!

The nanoparticles heated the testes to a temperature of 104 F, shrinking them and inhibiting spermatogenesis before gradual recovery 30 to 60 days after treatment.

That was with mice. Next step is to find grad students for human testing.

Seven places you should avoid

Seven south Georgia counties — Bacon, Charlton, Heard, Jeff Davis, Lanier, Telfair, and Treutlen — are now in the CDC red zone for spread of the Delta variant. And Charlton, with its 14.5 percent vaccination rate, is highest in the country for new Covid cases.

Two steps back

By the time you read this, the CDC is expected to have updated its guidance and once again recommend that everyone wear a mask while indoors in areas (like a lot of Georgia) where the Delta variant is spreading fast.

The idea is that unvaccinated people will start to take the virus more seriously, while vaccinated people will mask up to protect their unvaccinated neighbors. (There are breakthrough infections, but for vaccinated people the risk is minor.)

Eleanor Rigby might be over-using

If you’ve got senior patients who seem to be taking more and more drugs, they may not actually be sick — they could be lonely. A study out of the UC San Francisco found that the lonelier older people are, the more likely they are to use opioids, sedatives, and anti-anxiety meds. Oh, and antidepressants and OTC painkillers, too.

Contraindications may not come to light until a patient is suddenly hospitalized. “It’s only then that we might find out that a patient’s prescriptions include Valium and he’s been taking it for more than 20 years.”

No, the monkeypox saga isn’t over

Now it’s 43 people in Georgia being monitored for the disease, up from 26 last week. Move along, citizen, nothing to see here.

Coupla Covid notes

As scientists try to figure out what the heck is going on with long Covid, a new detail: nerve damage in the cornea. That’s not only slightly terrifying, it’s a clue as to why symptoms persist — it could have done damage specifically to small nerve fibers. Besides carrying signals like pain and itchiness…

Small-fiber nerve cells also help control involuntary bodily functions, such as heart rate and bowel movements; therefore, damage to these cells can cause a wide array of symptoms.

=AND=

Yet another reason to avoid this thing like the plague it is: A third (!) of Covid patients are diagnosed with a neuropsychiatric condition within six months of recovery. An Oxford University study looked at the health records of 81 million people, and the conclusion is based not on what people reported, but what their actual diagnosis was.

Anxiety, mood, and substance use disorders were most common, but the researchers also found worrying, if lower, rates of serious neurological complications, especially in patients who had been severely ill with Covid-19. In all Covid-19 patients, 0.6% developed a brain hemorrhage, 2.1% an ischemic stroke, and 0.7% dementia.

Just a reminder

There is no cure for Covid-19. In fact, there’s no surefire treatment — just a bunch of ‘stuff that seems to work at least some of the time.’

The cost of business

With a $26 billion opioid settlement getting closer to reality, you might be tempted to send thoughts and prayers to the drug distributors (and Johnson & Johnson) that are doing the settling.

But don’t you worry — they’ll be OK if the deal goes through.

Since 2016, the four companies involved in the latest opioid settlement — Johnson & Johnson, McKesson, AmerisourceBergen, and Cardinal Health — have funneled a combined $100 billion to shareholders through stock buybacks and dividends.

At least one state attorney general — Washington’s Bob Ferguson — has done the same math and said he won’t support the deal because it doesn’t “provide a transformative amount of money for state and local governments to address the opioid epidemic.”

Yes, what we need is another PBM

Lucky for us, that’s just what’s Anthem and Humana are launching with their partner, software maker SS&C. The two insurers are investing about $140 million for their stake in the new PBM platform: DomaniRx. It will, they say…

…offer its payer and provider users with data analytics and end-to-end transparency around drug costs—features that will help them better comply with the changing PBM regulatory environment.

Anthem, as you may recall, is not at all friends with Express Scripts, and it tried to launch its own PBM once before (the ill-fated IngenioRx). Humana has its own PBM, but it will be DomaniRx’s first customer.

Correction: An earlier version of this story misspelled the name of the new company. There is no “T” in it.

Not surprising, but still good news

The 2020–21 flu season was the lightest since the CDC began tracking it* — we’re talking a 1 percent positive rate, compared to a typical 25 percent. Amazing what wearing masks and hunkering down will do.

* It sounds like a long time, but it’s only been since 1997.

(Another) breast cancer breakthrough

If you have a mouse with breast cancer, good news: University of Illinois biochemists have found a drug they call ErSo that “quickly shrinks even large tumors to undetectable levels.”

It takes advantage of the estrogen receptor on tumor cells and effectively revs up the cancer cells’ protection system until it kills them. Oh, and then it goes on to kill the cancer where it’s metastasized, too.

“The unique thing about this compound is that it doesn’t touch cells that lack the estrogen receptor, and it doesn’t affect healthy cells — whether or not they have an estrogen receptor. But it’s super-potent against estrogen-receptor-positive cancer cells.”

Next up, human trials.

ARBs eke out win over ACE inhibitors

Sure, ACE inhibitors are the popular kid who gets all the prescriptions, but ARBs have fewer side effects — so found Columbia University researchers who looked at data from 3 million patients from around the world.

Both did their job, but those newer ARBs seemed just a wee bit safer.

Patients taking ACE inhibitors had a higher risk of cough and angioedema, but the study also found they had a slightly higher risk of pancreatitis and gastrointestinal bleeding.

Bottom line: If an ACE inhibitor is working well, leave it be. But for first-time users, maybe give an ARB a shot instead.

A (big) call for mandatory vaccinations

At least six pharmacy organizations — Academy of Managed Care Pharmacy, APhA, AACP, ACCP, ASHP, and the National Pharmaceutical Association — are among the more than 50 national healthcare organizations have called for mandatory Covid-19 vaccinations for healthcare workers.

We call for all health care and long-term care employers to require their employees to be vaccinated against COVID-19. (Emphasis theirs)

We stand with the growing number of experts and institutions that support the requirement for universal vaccination of health workers. While we recognize some workers cannot be vaccinated because of identified medical reasons and should be exempted from a mandate, they constitute a small minority of all workers.

Not long after…

The Department of Veterans Affairs has said that it will require most of its front-line health workers to get the vaccine.

Off and on

The bad news is that people trying to lose weight didn’t do so well at the beginning of the pandemic.

The good news, according to WW (formerly Weight Watchers) is that they got back onto their diets and continued losing weight after a few months.

If this doesn’t get guys to vaccinate, I don’t know what will

Getting infected with SARS-CoV-2 can cause both erectile dysfunction and male infertility. So found the researchers at the University of Miami’s Reproductive Urology Program. (Guys, I’ll spare you the details — let’s just say Covid-19 can affect both blood flow and sperm count.)

Take out some aggression

Those little clay disks are just asking for it, and GPhA’s giving you a chance to give it to ’em.

It’s the 2021 Ready. Aim. Phire! — a chance to shoot some obnoxious clay pigeons out of the sky while benefitting the Georgia Pharmacy Foundation.

Mark your calendars and check your liability policy — then sign up for the fun on Friday, September 24, from 1:00 p.m. – 5:30 p.m. at the Big Red Oak Preserve in Gay, Georgia. It’s open to both singles (we’ll group you up) and teams of four.

We’ll supply the guns, the ammo, the targets, and the training. You bring your eye and a love for the smells of gunpowder and barbecue. Join us to experience the natural beauty of one of Georgia’s finest sporting clays courses … and shoot things.

Click here for info and register today!

(Psst: There are a bunch of sponsorship options, too — check ’em out!)

Bigger ain’t better

Obesity is bad for you for a list of reasons (heart issues and diabetes for starters), but now Aussie researchers say you can add dementia to the list. Apparently “increased body fat incrementally leads to increased atrophy of grey matter in the brain and consequently higher risk of declining brain health.”

How so? They’re still investigating, but the current thinking is that “inflammation and metabolic abnormalities” are to blame.

ICYMI: “It’s too late”

An Alabama physician wrote an emotional Facebook post about dealing with the deaths of unvaccinated people.

“One of the last things they do before they’re intubated is beg me for the vaccine. I hold their hand and tell them that I’m sorry, but it’s too late.”

A few days later when I call time of death, I hug their family members and I tell them the best way to honor their loved one is to go get vaccinated and encourage everyone they know to do the same. They cry. And they tell me they didn’t know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin color they wouldn’t get as sick. They thought it was ‘just the flu’. But they were wrong.

Original post.

Elsewhere: Illinois’ new law

Illinois became the eighth state to allow over-the-counter contraception. Its new law “allows pharmacists to provide 12 months of hormonal contraceptives — such as birth control pills, rings and patches — without a prescription from a doctor.”

Money from UHC

Georgia is one of the 18 states (and D.C.) that will be receiving money from UnitedHealthcare — $500K, in our case — for help ‘addressing the social determinants of health’. In other words, to help lower-income people live healthier in general.

Grant recipients in Georgia include the National Birth Equity Collaborative, Atlanta Community Food Bank, Wellspring Living, Emory University, Open Hand Atlanta, and Hope Center (Albany).

The details about Georgia’s grants are here (PDF)

A chance to direct

Looking for a new challenge instead of the same ol’ same ol’ every day? How about, I dunno, Executive Director of Retail Pharmacy Operations for WellStar?

The company is looking for one to “plan, organize, and supervise all pharmaceutical and financial activities occurring in the WellStar Pharmacy Network” as part of WellStar’s renowned Department 100-7070700.

Get more info, the detailed job description, and a link to apply — it’s all right here.

Latest monkeypox news

Of the 200 or so people being monitored after potential exposure, 26 are in Georgia. Just so you know.

[P]eople being monitored include a number who sat within six feet of the infected individual on the Lagos-to-Atlanta flight; others who used the mid-cabin bathroom on that flight; airline workers who cleaned the bathroom after the flight; [and] flight attendants.

What oughta be a law?

You tell us. Seriously. It’s time for GPhA to start planning its 2021–22 legislative agenda, and that usually comes from membership — folks on the front lines.

Vaccine protocol expansion in 2015? Member idea. Medicaid audit protections? Ditto. Expanded point-of-care testing, the Pharmacy Patient Protection Act, the Audit Bill of Rights, anti-steering … all these came from members.

So let’s ask again: What oughta be a law?

If there’s a law or policy issue you want to see changed — something that will improve patient care or the practice of pharmacy — tell us about it! E-mail a brief explanation of the issue to our VP of public policy, Greg Reybold, at greybold@gpha.org. Yes, it’s that simple.

Your deadline: Friday, August 16, by 5:00 p.m. EDT.

Doug Hoey: International Man of Pharmacy

Congrats to NCPA CEO Doug Hoey, who was elected president of the World Pharmacy Council. He’ll be “tasked with leading the international group focused on building international recognition of community pharmacy, simultaneous with his leadership of NCPA.”

Pfizer vs. Delta

Israeli data show that the Pfizer vaccine is now only 39 percent effective against the Delta variant, but British numbers say it’s 88 percent effective. What gives?

Too many variables. How much the vaccine wears off over time. Whether early recipients were less healthy. Whether there are accurate data on infection levels. Whether unvaccinated people get tested. And so on.

What everyone does seem to agree on is that the vaccine is highly effective at preventing serious illness.

Drinks are on you

Pharmacist is ranked #20 in the latest US News & World Report ranking of the best-paying jobs in the country, between sales manager and business operations manager. (In the healthcare space, it’s ranked higher than optometrist, but below other healthcare professions including nurses, dentists, and OB/GYNs. The best-paying job? Anesthesiologist.)

Light up their lives

No one wants depressed mice, right? Here’s a trick Swiss biochemists discovered: Shine a bright light at them for 15 minutes in the morning. That apparently increases expression of a particular “clock gene” — one that plays a role in both mood and the circadian rhythm. (They tried the light at different times, and using it at the beginning of the “dark cycle” had no effect — it has to be near the end of that cycle; i.e., early in the morning.)

The great thing about light is that it’s safe, easy to administer, and nearly free, and it has a significant effect on the brain.

#Captainobvious’s friend’s cousin heard it’s not true

A study from the Journal of the National Cancer Institute “Shows Cancer Misinformation Common on Social Media Sites.”

Further, the vast majority of that misinformation has the potential to harm cancer patients by supporting approaches that could negatively impact the quality of their treatment and chances for survival.

Great news!

Global warming may give us more floods and wildfires, harsh winters and blistering summers, eroding beaches and migrating aardvarks, but guess what? It may limit the spread of dengue fever!

Mosquitoes carrying the virus are less tolerant of heat, so a warmer world is one where the disease spreads less. W00t!

Booby prize

Breastfeeding a baby is so good…

How good is it?

It’s so good, you only have to do it for a little while to reduce the kid’s blood pressure throughout childhood: “Babies who were breastfed, even for a few days, had lower blood pressure at 3 years of age than children who had never been breastfed.”

Technicians — your day is coming!

Mark your calendars, pharmacy techs! The biggest gathering of Georgia’s pharmacy technicians in … well, since the Before Times is coming…

TechU 2021: September 25 in Savannah

3 hours of CPE! Dinner! Drinks! Fun! More info coming soon, so watch your inboxes!

A loopy way to study migraines

You think migraine, you think pain — but motion sickness is also part of the package, and one that’s not studied nearly as much. So a German physiotherapist is working to change that in a cool way. She’s getting migraine patients sick by putting them in (on?) a virtual reality roller coaster while she studies their dizzy brains via fMRI.

The functional MRI showed that patients with migraine had more activity in a few areas of the brain, including the cerebellum; the occipital lobe, which is the area that processes vision; and the pontine nuclei, which is a small area of the brainstem.

She hopes the data can be used to get a better understanding of what’s going on in migraine sufferers’ heads — “the evidence from this and past studies hints at some kind of reduction in the inhibitory processes that normally dampen down unpleasant sensations.”

No no, don’t bother getting up

Exercise, they say. It’ll make you feel better. But it turns out that the Jetsons were right: It’s actually better just to take a pill. Or, more scientifically, ‘antidepressant therapy was superior to physical exercise in the medium term, despite giving rise to a greater number of adverse effects.’

Despite the fact that adverse effects were significantly greater in the AT group, both interventions were found to be satisfactory by the participants and favorably affected their self-perceived health status.

Meanwhile, in Opposite Land

Philip Morris — yes, that Philip Morris — is buying the Vectura Group … a maker of asthma medicines. Why? Because smoking is on the way out, and other delivery systems are the way the company will have to deliver nicotine. (And also, the company says, so it can go “beyond nicotine” to possibly even treat respiratory and other diseases.)

Thus this “$1.2 billion deal that would add fresh expertise in devices, inhalation, regulation, and clinical manufacturing.”

Probably worth worrying about

The first cases of the totally-antifungal-resistant strain of Candida auris have been reported in the U.S. — in Washington, D.C., and in Texas.

What makes these newly reported cases more concerning is the fact none of the people had been treated with antifungal drugs prior to the diagnosis. That means the strain of C. auris they caught was already pan-resistant.

For coffee, six is enough

Aussie researchers have some rare bad news about coffee drinking: While enough coffee is good for you in lots of ways, too much seems to, well, shrink your brain. And maybe lead to dementia.

It was a big study, too, looking at data from almost 18,000 patients. The big takeaway: Those who drank more than six cups of coffee a day — that’s about three typical U.S. mugs — had a 53 percent increased risk of dementia.

“[I]f you’re finding that your coffee consumption is heading up toward more than six cups a day, it’s about time you rethink your next drink.”

Wash big or go home

Here’s one way to get out the message that you need to wash your hands: Send the world’s largest bottle of soap on a U.S. tour. Soapmaking company Soapbox is doing that with a 21-foot tall, 2,500-pound metal and fiberglass bottle that will tour the country, stopping at various pharmacies and food stores while “donating pallets of soap and personal hygiene kits to local charities at every stop along the way.”

In New York, you’re gonna need a bigger bottle

That’s just lazy writing

As this season’s Delta-variant plot line continues to unfold*, the writers are already dropping some cliché teasers for next season. In this case, researchers at an Ohio State University dug up 15,000-year-old viruses from a Chinese glacier.

Money quote: “Most of those viruses, which survived because they had remained frozen, are unlike any viruses that have been cataloged to date.”

* We’re a bit worried about the upcoming episode, “Olympics of Doom”

Sure, why not?

“Coffee and veggies may protect against Covid-19” according to Northwestern medical researchers. Also protective: being breastfed (as a child, we presume) as well as eating fewer processed meats. The more you know.

Prison of debt

The latest figures (per a study published in JAMA) show that a whopping one in six Americans have medical debt in collections, and medical debt “now outweighs all other personal debt in U.S.,” especially in states that haven’t expanded Medicaid.

And when they say it outweighs other debt, they mean unpaid medical bills are more than all other sources of personal debt combined.

By the tail end of June 2020, individual Americans had a mean medical debt of $429 — $39 more than the combined average of all other non-medical debts such as credit cards, utilities and phone bills, the researchers wrote.

It gets worse: The data don’t take into account any medical debts incurred in 2020.

Guess who’s next

Drug distributors are close to a settlement for their role in the opioid crisis, which means those same states and localities will soon turn to their next targets: drug makers and pharmacies. Specifically (but not exclusively) we’re talking AbbVie, Endo, and Teva, and CVS, Rite Aid, Walgreens, and Walmart.

The pharmacies and drugmakers have denied the claims, saying rising opioid prescriptions were driven by doctors, that they followed federal law and that the known risks were included in U.S.-approved labels for the drugs.

And to keep things straight, those drugmakers are also currently defending themselves in New York and Orange County, California, while the pharmacies are looking at an October trial in Ohio.

PrEP is free

Health insurers will have to cover PrEP — the HIV prevention drugs (e.g., Descovy or Truvada) — at zero cost for patients. So say the feds:

The guidance that the Centers for Medicare and Medicaid Services, along with the Department of Labor and the Department of the Treasury, sent to health insurers Monday indicated that insurers have 60 days to comply with the mandate. The rule says insurers must not charge copays, coinsurance or deductible payments for the quarterly clinic visits and lab tests required to maintain a PrEP prescription.

The downside: People without health insurance will get the short end of the stick, because — while they might be able to get the drugs free (via drugmakers’ programs) — they won’t be able to afford the necessary lab tests or provider visits.

Jumping on the Covid bandwagon

There’s no cure for long Covid, but that won’t stop resorts and spas from offering treatment centers for it. Still feeling sick after the virus is gone? Why not…

…channel your inner Gwyneth Paltrow and pay $3,500 to have a therapist cake a paste of turmeric, galangal, and kaffir lime on your chest, cover it with an alcohol-doused towel, and set it all on fire.

Or inhale concentrated oxygen, practice chest muscle-strengthening exercises, have lasers shot at your head (“brain photobiomodulation”), or enjoy energy therapy (?), lymphatic drainage, and perhaps some electrolysis foot baths? And yes, every one of those is something actually being offered.

Don’t make any long-term plans

Thanks to a combination of Covid-19 and a surge in drug overdoses, life expectancy in the U.S. dropped 1.5 years in 2020, the largest drop since World War II.

Perspective: Previous drops of just 0.1 years in U.S. life expectancy were big news (in 2015, 2016, and 2017)

About three-quarters of 2020’s decline in life expectancy can be attributed to deaths from Covid-19, the CDC said, while 11% of the decline is due to increases in accidental deaths, including drug overdoses. Last week, the agency reported that a record 93,000 drug-overdose deaths occurred in 2020, which is a 30% increase compared with 2019.

J&J booster?

The Johnson & Johnson vaccine may not be as effective against Delta, according to a study out of NYU; boosters could eventually be necessary. This contradicts J&J’s own study that says the shot works against the variant for at least eight months.

[T]he conclusions add to evidence that the 13 million people inoculated with the J.&J. vaccine may need to receive a second dose — ideally of one of the mRNA vaccines made by Pfizer-BioNTech or Moderna, the authors said.

The Long Read: A simple number

In a rare positive article* in the Atlantic, we learn that scientists are getting close to finding a single, easy-to-measure number — a correlate of protection — that will tell whether a Covid-19 vaccine is effective in general … and whether a single individual is protected.

If confirmed, these correlates could revolutionize the way we tackle SARS-CoV-2 immunization: Vaccine makers testing a new inoculation may no longer need to follow tens of thousands of people for many months to test their product’s protection.

*Fear not, as the magazine continues its negativity with “Vaccination in America Might Have Only One Tragic Path Forward“

Chantix recall

Irony alert: Pfizer is recalling 12 lots of its Chantix anti-smoking drug because of a possible carcinogen — N-nitroso-varenicline.

Best hedging of the week: “Long-term ingestion of N-nitroso-varenicline may be associated with a theoretical potential increased cancer risk in humans.”

Urgent, urgent, emergency

HHS has determined that a public health emergency still exists.

Or, as only a bureaucrat could put it:

As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective July 20, 2021, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, that a public health emergency exists and has existed since January 27, 2020, nationwide.

Coming soon: “Xavier! the Musical”.

Of course we want you back!

Thanks to you, GPhA has weathered the last 12 months, despite the pandemic.. And we want you back for the next 12. In other words … it’s time to renew your membership!

Do we really have to list everything we accomplished?

Maybe you don’t read every legislative update word for word, but you must realize that there are people out there who would make your job harder, more expensive, or less worthwhile — and GPhA is there to make sure that doesn’t happen.

Your dues supports our advocacy efforts including our full- and part-time lobbyists. Your dues fund education programs, networking events, information resources (like the one you’re reading now), and a lot more*.

And your membership pays for itself in discounts — discounts on continuing ed, convention registration, and certification programs. Not to mention what our advocacy work can save the business you own or work for.

So less reading, more renewing. You — yes, you — are the heart and soul of GPhA. We want to keep you around, and we want to keep doing good for you.

Go, please: GPhA.org/renew. And thank you.

* Like convention, region meetings, members-only resources, Georgia Pharmacy magazine, continuing ed on the latest topics…

Don’t inhale

To add injury to injury, there seems to be a good chance that Covid-19 patients will injure their lungs because they have to work so hard to inhale.

Because “So-called patient self-inflicted lung injury is a controversial concept in the intensive care community,” British researchers did what anyone who grew up with “Star Trek” would: They asked the computer.

The results of the simulations indicated that potentially injurious pressures and strains could be generated at levels of respiratory effort that clinicians are frequently seeing in Covid-19 patients.

To make it worse, mechanical ventilators are also known to damage lungs, so really, the best option is to get vaccinated.

There’s a new sheriff in town

Trump administration: Hospitals, you have to publish your prices so everyone can see and compare them.

Hospitals: We don’t want to. Something something competition secrets blah blah blah.

Trump administration: We’ll fine you $109,500 a year if you don’t.

Hospitals: Law, schmaw. We won’t publish them.

Biden administration: We’re gonna start enforcing that law. Oh, and that $109,500 penalty? We’ll make it $2 million.

Monkeypox chronicle continues

The latest about the nothing-to-worry-about case of monkeypox being treated in Dallas: The CDC is monitoring more than 200 people across 27 states who may have been exposed to Patient Zero.

Passengers on the Atlanta-Dallas flight with indirect contact — in other words, those sitting near the infected person — were deemed to have had too short an exposure to be at risk.

Fixing the messengers (and treating diseases)

Messenger RNA carries instructions to ribosomes: Build this protein. But if that mRNA gets screwed up in a particular way — a “nonsense mutation” — it might incorrectly put a “Stop Here” message in its recipe. You end up with missing or incomplete proteins, which can lead to diseases like cystic fibrosis.

But now University of Alabama biochemists have found a nifty little molecule called SRI-37240 that can tell those ribosomes “Ignore that Stop sign.” Even better, it doesn’t prevent the ribosomes from obeying the correct Stop signs.

All this means that “a path is clearly achievable” to treat a host of genetic diseases caused by nonsense mutations, including cystic fibrosis, Duchenne muscular dystrophy, and even some cancers.

Delta at 83

83 percent, that is. The latest CDC figures show that 83 percent of Covid cases that are sequenced in the U.S. are the fast-spreading Delta variant that’s clobbering unvaccinated communities across the country.

Settlement news

Why yes, that multi-state, multi-city, multi-everything opioid lawsuit is still going on. But there may be a $26 billion settlement … if everyone agrees to it. (So far it looks like 40 states have.)

But don’t you worry! “The fees of lawyers, who pursued and financed the costly litigation for years, will be deducted from the total figure and are expected to be paid more quickly than some funds for addiction treatment.”

Elsewhere

In New York, however, Amerisource Bergen, Cardinal Health, and McKesson have reached a separate $1.1 billion, 17-year settlement with that state. (Of note: New York has passed a law requiring that the money from the settlement only be used to pay for the effects of the opioid epidemic.)

Don’t read this

A microbiologist explains how “Your bed probably isn’t as clean as you think.”

Well that’s not good at all

So that guy in a Dallas hospital with monkeypox? He came through Atlanta. (Cue the dramatic music.)

Making CO work for you

Carbon monoxide is usually bad stuff — that’s why it’s often followed by “poisoning.” But in small doses, like Adam Sandler movies, it can do some good. In monoxide’s case, it’s by reducing inflammation in organs like the kidneys or lungs.

The trick is the delivery; you can’t just swap out patients’ oxygen for monoxide like in a Folger’s commercial.

But Georgia State chemists have a way. They found that they can make “carrier” molecules using the ingredients from artificial sweeteners. They enter the blood stream and dissolve where needed, releasing carbon monoxide in the process. That allows delivery of the drug to the affected organ without anyone having to sit next to a tailpipe.

Captain Obvious eats his chicken soup

Despite being given to lots of Covid-19 patients, an antibiotic (azithromycin) was no more effective than a placebo against the virus.

A scam warning from Pharmacists Mutual

Apparently, phone scammers are targeting pharmacies.

[T]he pharmacy receives a call from someone pretending to be from a legitimate medical supply vendor known to the pharmacy, such as McKesson or Cardinal. The caller states that they are performing maintenance on the system and need the employee’s user name and password for testing purposes. The employee then, unfortunately, gives the sign-on credentials to the caller.

We know Buzz readers are too smart to get caught by something like this, but just in case you know someone who should be aware….

Go nano or go home

Sure, radiation works against cancer, but it does a lot of damage to other cells, too. What’s it missing? Nanoparticles, of course.

[R]esearchers in Japan have developed nanoparticles that can penetrate tumors and kill them from within, after being activated by external X-rays.

Those nanoparticles carry iodine, which releases electrons once it’s inside the tumor and hit by the (much lower dose of) radiation: X-rays, in fact. Bam — dead tumor.

Another good thing coffee can do for you

The more of it you drink (say cardiologists at UC San Francisco) the lower your risk of arrhythmia. In fact, after looking at the data of 386,258 Brits, they concluded that “each additional cup of habitual coffee consumed was linked to a 3% lower risk for incident arrhythmia.”

So if you want zero chance, that would mean drinking … 33+ cups a day. We wish you luck.

You might want to avoid Savannah for a little while

Savannah and Chatham county’s Covid infection rate has shot up high enough to put it back in the red zone, and hospitalizations are at the highest level since March. Remember March? March wasn’t good.

Only 41 percent of the county has been fully vaccinated, mostly those over 65. The big fear: Parts of Georgia becoming like parts of Missouri.

A bit of good news

Here’s something positive: : Kids who get multisystem inflammatory syndrome (MIS) as a result of Covid-19 (C) only have to deal with it for a few months after infection — at least, so found researchers at Columbia University. Granted, it’s not a great few months — MIS-C puts kids in the ICU with heart problems — but it’s better than at least one alternative.

Pfizer settles over EpiPen prices

The company agreed to pay $345 million to patients who overpaid for their EpiPens “due to anticompetitive and unfair practices by the drugmaker and the company that markets the emergency allergy treatment, Mylan.”

This is fallout from waaaaaay back in 2016, when Mylan raised the price of EpiPens 600 percent and the New York Times reported that Mylan’s board chair, Robert Coury, used, um, colorful language to describe critics.

Mylan has since merged with Pfizer’s Upjohn to form Viatris.

Antibiotics too early?

Giving kids antibiotics before they’re two years old might change their microbiome enough that it affects the gene expression in their brains. So found Rutgers researchers who suggest “reducing widespread antibiotic use or using alternatives when possible to prevent neurodevelopment problems.”

“Our previous work has shown that exposing young animals to antibiotics changes their metabolism and immunity. The third important development in early life involves the brain. This study is preliminary but shows a correlation between altering the microbiome and changes in the brain that should be further explored.”

Cancer GPS

What if you could use a urine test not only to detect if someone had cancer, but exactly where that cancer was? You’d obviously have to use nanoparticles, like all the cool kids, and that’s just what engineers at MIT came up with.

Their nanoparticles “can detect specific cancer-associated molecules that circulate in bodily fluids,” telling doctors both what and where the cancer is:

It can reveal the presence of cancerous proteins through a urine test, and it functions as an imaging agent, pinpointing the tumor location. In principle, this diagnostic could be used to detect cancer anywhere in the body, including tumors that have metastasized from their original locations.

This again

Yet another case of H5N6 bird flu has been found in a human — this one in Bazhong, China. Fear not, as local officials “activated an emergency response and sterilized the area,” which doesn’t sound terrifying at all.

And then this

A man in Texas has been diagnosed with monkeypox — the first such case in the U.S. in 20 years. He had just flown back from Nigeria (presumably to meet with a prince to collect his millions). The other passengers are probably very glad masks were required on the flights.

Listen to your elders (they may have dementia)

On Thursday we told you about using GPS to potentially detect Alzheimer’s by monitoring someone’s driving. But what if Grandpa won’t go for that? Japanese researchers have another way: an algorithm they say can detect the onset of dementia just by hearing phone conversations — live or recorded.

In fact, testing showed that their machine-learning system was as good at predicting Alzheimer’s as existing cognitive tests.

More creepy-crawlies

Yesterday it was spiders and caterpillars with potentially helpful venom. Today we’ll go with tarantulas and snakes.

Bioengineers led by Canada’s Western University are working to turn the blood clotting enzyme reptilase — it comes from the venom of the deadly (and usually-in-South-America) lancehead snake — into surgical glue that’s both stronger and faster to set than today’s clinical fibrin glue.

Meanwhile, entomologists at UC Davis are looking at using the venom of the Peruvian green velvet tarantula…

…to keep pain signals from transmitting between nerves and muscles. This spider’s venom has a particular peptide associated with a specific channel that transmits pain.

The goal is a pain treatment as strong as opioids without the side effects.

Instead of a spider, here’s a kitten. You’re welcome.

The long-Covid list

The Brits have done a big survey — 3,762 persons across 56 countries who have various symptoms even after recovering from Covid-19. The result: 203 symptoms of long Covid, including 66 that lasted at least seven months.

The most common symptoms were fatigue, post-exertional malaise (where people’s health worsens after physical or mental exertion) and brain fog. Other effects included visual hallucinations, tremors, itchy skin, changes to the menstrual cycle, sexual dysfunction, heart palpitations, bladder control issues, shingles, memory loss, blurred vision, diarrhoea and tinnitus.

Golf … with guns!

Well, no, not really golf, but yes to the guns. It’s the 2021 Ready. Aim. Phire! — a sporting clays event
benefitting the Georgia Pharmacy Foundation.

Mark your calendars and update your insurance: Friday, September 24, from 1:00 p.m. – 5:30 p.m. at the Big Red Oak Preserve in Gay, Georgia. It’s open to both singles (we’ll group you up) and teams of four. We’ll supply the guns, the ammo, the targets, and the training. You bring your eye and an intense hatred of airborne clay disks.

Join us for an afternoon of outside adventure*, (friendly) competition, the smells of barbeque, beer, and gunpowder, and the natural beauty of one of Georgia’s finest sporting clays courses.

Click here for info and register today!

(Psst: There are a bunch of sponsorship options, too — check ’em out!)

* How can you go wrong with both guns and adventure?

Sunscreen recall

Johnson & Johnson is recalling some Neutrogena and Aveeno aerosol sunscreens because they contain benzene. Check yer shelves:

• Neutrogena Beach Defense aerosol
• Neutrogena Cool Dry Sport aerosol
• Neutrogena Invisible Daily defense aerosol
• Neutrogena Ultra Sheer aerosol, and
• Aveeno Protect + Refresh aerosol

How diabetes hurts

Diabetes often leads to heart disease, but how that happens hasn’t be clear … until now. British researchers have figured out that high levels of glucose literally reprogram stem cells in bone marrow to produce inflammatory immune cells in the blood. Being inflamed, they’ll help increase the buildup of arterial plaque, like a slow buildup of hair in a drain.

“Our study is the first to show that diabetes causes long-term changes to the immune system, and how this might account for the sustained increase in the risk of heart attack.”

Another problem with anticoagulants

Brazilian endocrinologists have discovered a potentially troubling connection: Taking oral anticoagulants, whether direct-acting or warfarin, can lead to lower bone density and quality — but warfarin users were affected the most.

“[B]one microarchitecture assessed by trabecular bone score, […] was more degraded in the warfarin group compared with the direct-acting oral anticoagulant group, and more degraded in the direct-acting oral anticoagulant group compared with the control group.”

From death comes life

If Australia is known for one thing, it’s “Everything wants to kill you.” But there are at least two species that might be slightly more helpful (although still deadly).

First is the funnel-web spider — known as the deadliest spider in the world, but whose venom contains a protein called Hi1a that might be able to protect cardiac cells during a heart attack (presumably caused by coming across a funnel-web spider). It might also help extend transport time for hearts to be transplanted.

Choose the form of the destroyer

Second is an adorable little caterpillar called Doratifera vulnerans (literally “bearer of gifts of wounds”) with venom that can cause extreme pain. That venom, though, was just found to be chock full of bioactive peptides “containing 151 different protein-based toxins from 59 different families.”

Sure, those toxins might kill a few unlucky grad students, but experience tells us that they might also lead to any number of treatments. But … “First, we need to work out what the individual toxins do, to inform us about how they might be used.”

Diabetes and depression

People with diabetes have a higher risk of also having depression, but it’s even more important for them to consider antidepressants. Why? Because, as a new study of more than 36,000 people found…

“People with depression and diabetes have poorer health outcomes than those with diabetes alone, and regular antidepressant treatment could lower their risk of complications.”

Depression, they say, adds stress, reduces exercise, and makes those complications worse; adding an antidepressant can have a much bigger impact.

Link above is to the study; here’s the news story.

Elsewhere: “The UK Has Had Enough” edition

Some generic-drug makers in the UK raised their prices for hydrocortisone tablets by an eye-popping 10,000% over 10 years. (They also paid off competitors not to enter the market.)

Governments may be slow, but they do tend to catch on, and now those companies will be shelling out $305 million (£221 million) in fines to Her Majesty’s Government for their “excessively high prices.” And that’s before the National Health Service decides to seek damages.