A pharmacist's look at the supermarket and beyond

Month: September 2017

No to Graham-Cassidy bill

This is what I sent to my Senators:

The Graham-Cassidy bill threatens the health of anyone who is sick, has ever been sick, or who will become sick in the future. This bill is disastrous and will result in coverage being prohibitively expensive for those most in need of it. This bill serves to maximize profits to the corporations that indirectly manipulate health care, at the expense of patients and those of us that provide direct patient care.

The bill would decimate Medicaid, endangering access for millions of Americans. This would have a huge negative impact on low-income individuals and families affected by diabetes and other chronic diseases. Adults with diabetes are disproportionately covered by Medicaid. In Medicaid expansion states, more individuals are being screened for and diagnosed with diabetes than in the states that did not expand. As a pharmacist, I play a key role in helping people manage this insidious disease. Diabetes and its complications can be managed but patients need help to overcome the outrageous drug costs made possible by our Congress. I have had enough of health care executives pulling down multi-million dollar compensation with bonuses that are essentially based on denial of care to those that need it.

I also can see that the strategy of providing block grants will lead to diminished care and programs for special needs patients of all ages, with many good programs that provide pathways for these special people to contribute to society at risk of being eliminated.

I strongly urge you to focus on bipartisan efforts like market stabilization, taking an unbiased look at a modest “safety-net’ Medicare expansion that eventually reaches all Americans, while leaving plenty of viable marketplace options for non-catastrophic coverage. I believe it can be done.

For now, please vote NO on the Graham-Cassidy bill.

I thank you for your service and your desire to do the right thing for your constituents.

I am happy to discuss any facet of health care, because, I believe that through mutual understanding and similar ideals, we may reach a consensus.

(thanks for the form letter seed from American Diabetes Association)

Spiders, Venom, and Pain – Oh My!

Spiders, more specifically their venom, are the next enticing source of pharmaceuticals. Many of the peptides found in various species of spiders’ venom are pharmacologically active. We are acutely aware of the nasty neurotoxic effects but other components of venom demonstrate a variety of drug-like effects, including analgesic, antimicrobial, hemolytic, antiarrhythmic, and even enzyme inhibition. The possibilities for drug discovery are enormous.

Spiders are the most prevalent venomous species on the planet. Since most spider venoms are actually a complex mixture (a toxtail, if you will), of mostly peptides along with some other organic compounds. It is estimated that there could be over 12 million unique peptides produced by the venomous portion of our 100,000+ species. So far, we have just scratched the surface, with the latest total on the ArachnoServer listing over 1500 toxins from just 100 species. This database curates data from UniProt, a scientific consortium, with a mission to “provide the scientific community with a comprehensive, high-quality and freely accessible resource of protein sequence and functional information.” The ArachnoServer itself also uses the World Spider Catalog for its taxonomy identification. No mention of radioactice spiders here.

Most peptides do not make for good drugs because of their innate instability and limited human absorption. But here is where spider venom gets really cool. It turns out that in most spider toxins the biologically active peptide is “packaged” in what is called a “inhibitor cystine knot (ICK),” which essentially embrace the peptide to create a very stable mini-protein. Crazy shtuff. Without getting too deep into this science, suffice it to say that new studies are looking at oral dosage forms for humans. The ICK peptides are resistant to pH extremes, proteolytic enzymes, and high temperatures.

The most exciting area of spider venom research is in the area of treatment of chronic pain. In light of our current opioid dilemma, the possibility that we could have a non-addictive pain reliever is exciting. Our growing knowledge of certain neural ion channels playing a role in the inception and perception of pain, coupled with our growing knowledge of these spider peptides, may lead to some new effective remedies. A group of researchers in Australia is studying the peptide toxin – known as ProTx-II – that inhibits pain signals by binding to the membranes of nerve cells. This toxin is found in the venom of the Green Velvet Tarantula.

We already have pharmaceuticals derived from venom found in the animal kingdom. Pharmacists will know the drug the venom-derived drug approved by the FDA, exenatide (a glucagon-like peptide-1 agonist), which helps treat type 2 diabetes. It was originally isolated from the saliva of the Gila monster, a venomous lizard.

There is a pretty good article from the British Journal of Pain here at the NIH.