Therapeutics

Biologists develop new method for discovering antibiotics

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Science Daily: “Biologists at the University of California, San Diego have developed a revolutionary new method for identifying and characterizing antibiotics, an advance that could lead to the discovery of new antibiotics to treat antibiotic resistant bacteria. The researchers made their discovery by developing a way to perform the equivalent of an autopsy on bacterial … Read more

SharePractice – a collaborative clinical reference for physicians

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Here’s an interesting concept. SharePractice is an application that uses the idea of crowdsourcing other physicians to rank treatments for various disease states. “Good doctors make bad decisions because knowledge sources are incomplete and static. Medical reference tools are biased by business interests and take too long to update. Reading research papers is an antiquated … Read more

Impact of alcohol intake on medication adherence [abstract]

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Does alcohol consumption impact medication adherence? I don’t know, but it’s a fair question. I would assume that it all depends on when you drink, how much, how often, if there’s any correlation between drinking time and medication consumption, age and social status of the patient, and so on. The variables one would have to look at would be quite extensive in my opinion. We’re talking about human behavior here, which is notoriously difficult to quantify and control.

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Tight glycemic control has no proven benefits for children in the cardiac ICU [article]

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It looks like we’re still beating this dead horse. I thought we put the tight glycemic control issue to bed a while back. Then again I’ve been out of the game for quite some time, so it’s quite possible that I’ve missed something. Actually, it’s likely I’ve missed something. Tight glycemic control was all the … Read more

New hydrogel research gives new meaning to “sustained released” medication

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Medical Xpress: “Researchers from the University of Cambridge have developed injectable, reformable and spreadable hydrogels which can be loaded with proteins or other therapeutics. The hydrogels contain up to 99.7% water by weight, with the remainder primarily made up of cellulose polymers held together with cucurbiturils – barrel-shaped molecules which act as miniature ‘handcuffs’….  The … Read more

Biased pain medication prescribing

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KevinMD.com: “Undertreated pain is worse than addiction.” On one end is the doctor who is deeply, morally troubled by patients in pain. This doctor is not unaware of the risk of addiction but is willing to risk being taken advantage of by a wily narcotic seeker rather than leave pain untreated. This doctor knows that … Read more

Scientists find new mechanism behind resistance to cancer treatment

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Medical Xpress: “A team of scientists led by Fred Hutchinson Cancer Research Center has discovered a key factor that drives this drug resistance [chemotherapy resistance].Nelson and colleagues found that a type of normal, noncancerous cell that lives in cancer’s neighborhood – the fibroblast – when exposed to chemotherapy sustains DNA damage that drives the production of a broad spectrum of growth factors that stimulate cancer growth. Specifically, the researchers found that DNA-damaging cancer treatment coaxes fibroblasts to crank out a protein called WNT16B within the tumor neighborhood, or microenvironment, and that high levels of this protein enable cancer cells to grow, invade surrounding tissue and resist chemotherapy.” – Interesting finding. I suppose that means we’ll be looking at WNT16B inhibitors soon? Probably not soon. A quick Google search revealed that that protein may contribute to several other processes in the human body.

Article from Nature Medicine below.

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Pharmaceuticals from crab shells

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This is pretty cool stuff. Vienna University of Technology: “Fungi with additional foreign genes have been created at the Vienna University of Technology. They can now turn chitin into pharmaceuticals. Usually, mould fungi are nothing to cheer about – but now they can be used as “chemical factories”. Scientists at the Vienna University of Technology … Read more

Med Adherence – Difference between prescribed and dosing histories [Article]

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Annual Review of Pharmacology and Toxicology (2012 Feb 10;52:275-301. Epub 2011 Sep 19) – No big surprise here, but check out the graphs (posted below), especially the second one where you can see the effect poor compliance/adherence has on therapeutic concentration. Crazy.

Abstract

Satisfactory adherence to aptly prescribed medications is essential for good outcomes of patient care and reliable evaluation of competing modes of drug treatment. The measure of satisfactory adherence is a dosing history that includes timely initiation of dosing plus punctual and persistent execution of the dosing regimen throughout the specified duration of treatment. Standardized terminology for initiation, execution, and persistence of drug dosing is essential for clarity of communication and scientific progress. Electronic methods for compiling drug dosing histories are now the recognized standard for quantifying adherence, the parameters of which support model-based, continuous projections of drug actions and concentrations in plasma that are confirmable by intermittent, direct measurements at single time points. The frequency of inadequate adherence is usually underestimated by pre-electronic methods and thus is clinically unrecognized as a frequent cause of failed treatment or underestimated effectiveness. Intermittent lapses in dosing are potential sources of toxicity through hazardous rebound effects or recurrent first-dose effects.

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