Meds

Novavax may be able to provide equitable access to another vaccine alternative

Meds
July 7, 2022

On June 7th, 2022, the Novavax COVID-19 vaccine was approved for use in adults by the Vaccine Advisory Committee of the United States Food and Drug Administration. The vaccine has already been authorized in many other nations, including Indonesia, the United Kingdom, Canada, Australia, and more, making the U.S. one of the last major nations to approve the vaccine.

The technology behind Novavax differs from the already prominent …

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The promise of in silico drug development to improve patient outcomes

Meds
July 2, 2022

In the last two years, pharmaceutical companies have become increasingly interested in the possibilities in silico technologies bring to the world’s multi-billion-dollar drug development market. Among the factors that have been reported as drivers of recent interest in what is also known as virtual clinical trials are the COVID-19-related restrictions that began impacting traditional human-based clinical trials in 2020.

In silico drug development utilizes real-world data (RWD), artificial intelligence (AI), computational …

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Allow patients to continue their opioid of choice while starting microdoses of buprenorphine

Meds
June 16, 2022

Twenty-six hours into the shakes, sweats, crawling anxiety, and gripping nausea of opioid withdrawal, Faye caves in and takes a couple of fentanyl tabs. She knows that she must tough out a couple of days without fentanyl to start Suboxone (buprenorphine/naloxone) through a medication-assisted treatment program, but the sickness gets the better of her. Those couple of tablets reset the clock on her withdrawal.

Starting buprenorphine – an evidence-based …

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Automatic refill and 90-day fill programs don’t improve medication adherence

Meds
May 20, 2022

Health care has fooled us into believing a number of myths that—taken at face value—sound logical and true. Here’s one of the most pervasive and dangerous myths: Pharmacy’s value comes from convenience and access. And here’s another one: 90-day fills, and automatic refills on prescriptions improve medication adherence and patient health.

It’s not surprising that people might champion the efficacy of these tactics. It feels easier to get 90 days of …

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Are psychedelics the heroes or villains?

Meds
May 13, 2022

Like many fellow Americans, I had my first psychedelic experience in the middle of the pandemic, in a place where the use of psychedelics is decriminalized.

I grew up in a Communist country, and the ban and stigma against psychedelics were tremendous. There was no plant medicine available, and I didn’t know even one person using anything other than alcohol and prescription drugs.

I read Michael Pollan’s book How …

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Before taking Paxlovid, consider these drug interactions

Meds
April 7, 2022

FDA and Health Canada recently approved Paxlovid as an oral treatment option for mild-to-moderate COVID-19 who are at high risk of progression to severe COVID-19. It is a combination drug containing nirmatrelvir/ritonavir. Nirmatrelvir works by binding to SARS-CoV-2 3CL protease to ultimately stop viral replication. Ritonavir does not have any antiviral activity against COVID-19 but increases concentrations of nirmatrelvir by decreasing its metabolism by CYP3A4 enzyme. Ritonavir is …

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The true story of morphine milligram equivalents

Meds
March 26, 2022

They are the foundation of the CDC’s 2016 opioid guidelines, resulting in legislation limiting opioid prescribing in 36 states. Morphine milligram equivalents, or MMEs, are used to set arbitrary prescribing limits for opioids by physicians since many state legislators fail to understand — and translate into policy and law — the ’16 guidelines. If we had all known the history of MMEs, perhaps we would not have been so eager …

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Concerns about the generic formulations of ADHD medications

Meds
March 25, 2022

I love generic brand products. I will fight to the last breath for my Shoppers’ Choice Adhesive Bandages rather than pay an extra $0.49 for Band-Aids. So why, then, have I been paying up to $395 every month for brand-name medication for the last two years instead of getting the generic version for $7.56? After all, aren’t generic drugs the same as their brand-name counterparts?

Let’s go back to November 2019, …

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To treat future COVID variants, we need more than vaccines

Meds
March 13, 2022

The world is constantly trying to keep up with the latest COVID-19 variant – from Alpha to Omicron and now Omicron’s cousin BA.2, we have seen how contagious and virulent these variants can be. Viruses are wily adversaries, and they mutate both to avoid detection and to defeat the body’s immune responses from vaccines and previous infections.

Even if vaccines continue to be effective at preventing severe illness and death from …

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People over profit: Pfizer and Moderna must share vaccine technology

Meds
March 3, 2022

One year ago, the FDA granted emergency use authorization of mRNA COVID-19 vaccines in the U.S., and nearly 549 million total vaccine doses have been given since. These vaccines have been safe, effective methods in preventing infection and death from COVID-19.

Vaccine recipients had a lower overall risk of death from non-COVID-19 disease compared to unvaccinated counterparts.

Among available vaccines, …

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Medication management and how consultant pharmacists can help

Meds
February 22, 2022

Management of medications is sometimes handled sub-optimally, at least in the United States. At the extreme, physicians who prescribe multiple medications prescribe some medications that treat the side effects of other medications. This could be considered physician negligence in extreme cases.

An example was given in a class I took at UCSF (the University of California at San Francisco). UCSF physicians jointly provided remote advice for a physician treating a developmentally …

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Patients are captive pharmacy benefits manager consumers

Meds
February 16, 2022

I still recall the ICU physician holding my hand and preparing me for the possibility I might not survive the blood clots in my lungs, pulmonary embolism. It was eighteen years ago when out of the blue, I found myself unexpectedly holding the hand of that gentle, concerned doctor, whose name I do not even know. My son was three years old at the time, and all I could think …

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What doctors need to know about psychedelic medicine

Meds
February 11, 2022

Frustration.

If you’ve treated patients with PTSD, I’m guessing that both you and your patients have experienced frustration at numerous points along the treatment course. And it’s understandable – up until this point, the efficacy of PTSD treatments has been notoriously poor. The best options aimed to diminish the severity of symptoms with a combination of therapy and daily medications.

However, the …

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COVID-19 and the Tuskegee syphilis study

Meds
January 12, 2022

Despite health professionals’ efforts at conveying the effectiveness of immunization, many African Americans remain skeptical about the COVID-19 vaccine.

Getting to the root of this distrust is critical as the Delta and Omicron variants stoke up the number of positive COVID-19 cases across the United States. And the spread of the virus is not uniform. According to the National Vital Statistics System, Black Americans incur the highest COVID-19 …

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Covaxin: Doomed to the dugout or ready to join the field of vaccine options?

Meds
January 7, 2022

With apologies to the late Yankees slugger Yogi Berra, for pandemic-weary Americans, it’s like “déjà vu all over again,” as new lockdowns and mandatory mask mandates are being imposed across the globe.

The latest threat, the Omicron COVID-19 variant, has been a major source of breakthrough infections, including among those who have been fully vaccinated and boosted, such as United States Senators Elizabeth Warren and Cory Booker.

Pfizer, Moderna, Johnson & Johnson, …

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How drug distributors contributed to the opioid crisis

Meds
December 28, 2021

A recent headline in my neighborhood newspaper read, “A Dentist Became a Top Opioid Buyer in W. Va. Now a Drug Firm Faces Penalty for Ignoring Red Flags.” The drug firm sent 25,400 hydrocodone pills and 3,600 Xanax to one Huntington, WV area dentist. The DEA raided the dentist’s office and shut it down. The dentist admitted to ordering the pills for personal use.

This summer, also right …

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COVID-19 monoclonal antibodies are a bridge to vaccination

Meds
December 18, 2021

Attention-grabbing headlines suggest that our crucial COVID-19 pandemic tools—monoclonal antibodies and vaccines—are incompatible. Beyond the controversy rests an evidence-based reality: monoclonal antibodies and vaccines are complementary aspects of patient care. Both are powerful interventions that can prevent hospitalizations and deaths from this virus. After weeks of declining cases and hospitalizations, the United States is experiencing another surge of new infections likely due to multiple factors, including relaxed mask use in …

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Is Descovy really the better option?

Meds
December 12, 2021

When the FDA approved Gilead’s Truvada (emtricitabine/tenofovir disoproxil) for HIV PrEP in 2012, it was a revolutionary step forward. The drug was safe and up to 99 percent effective in preventing HIV infection in at-risk individuals.

Then in 2019, Gilead received FDA approval for a second drug for PrEP called Descovy (emtricitabine/tenofovir alafenamide), with equivalent efficacy to Truvada. Recent research has shown that by the end of 2020, …

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How did we let insurers run health care?

Meds
November 15, 2021

How did we Americans allow health insurers to dictate how physicians practice good medicine? The hypocritic oath says, “Do no harm.” We should not allow insurance company profits to prevent proper care for patients.

Our insurer is now telling our young adult son, a Crohn’s patient (Crohn’s is not yet a curable disease), who has been in remission since he began taking Remicade over 11 years ago to switch to a …

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The people vs. opioid pharma: Pharma wins again

Meds
November 14, 2021

On Monday, November 1, an Orange County California Superior Court Judge said, in a tentative decision, that the opioid pharmaceutical companies were not responsible for the opioid crisis.

This particular case, going by the name of “The People of the State of California v. Purdue Pharma,” started in 2014. The judge’s ruling noted that neither party requested a trial by jury. The trial took place before the judge between April 19, …

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CME Spotlights