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Relationship between Diabetes and
Alzheimer's
Nearly 21 million Americans in the United States have diabetes, a disease that
makes the body less able to convert sugar to energy. Scientists are finding more
evidence that could link Type 2 diabetes with Alzheimer’s disease, the most
common form of dementia and the seventh leading cause of death in the United
States. Recent reports revealed that impaired insulin signaling in the brain,
often a feature of diabetes, may negatively impact cognition, mood, and
metabolism all of which are common aspects of Alzheimer's disease. Although
the conditions are seemingly independent of each other, earlier studies have
found that people with type 2 diabetes are more likely to develop Alzheimer's
disease. However, the mechanisms behind this relationship have remained
hidden.
A recent study investigated the impact of blocking insulin receptors and
insulin-like growth factor (IGF1) receptors in mouse models. The work was
carried out at the Joslin Diabetes Center, affiliated with Harvard Medical
School in Boston, MA. The results reveal that interrupting these similar
pathways impaired both learning and memory.
Insulin receptors and learning
The researchers worked with both the hippocampus and the central amygdala,
areas of the brain that help with cognition function, as well as metabolic
control. They looked into how mice with disabled insulin and IGF1 receptors
tackled mazes, and the results were revealing.
VOLUME 36 ISSUE 4
Medical News
––
October – December 2018
In this issue .. ..
Medical News ------------- 1
Pharmaceutical
Authorities News --------4
Medication Safety
Updates -------------------- 5
7 ---------------- الصفحة العربية
Scientific Books: New
Release -------------------- 8
Now The bulletin is available online at: https://pharmacy.ksu.edu.sa/ar/node/1397
Both Bacteria and
Viruses Can Cause
Pneumonia, But One
Is Much Worse for
the
Both bacteria and viruses can cause
pneumonia, an infection
characterized by inflammation in
the air sacs of the lungs . In the
study, the researchers looked at
data from 2007 to 2014 on around
4,800 patients at a Utah hospital
who had been diagnosed with
pneumonia and hospitalized.
Around 80 percent of the patients
had been diagnosed
with bacterial pneumonia. The
researchers found that 34 percent of
the patients with bacterial
pneumonia had a major heart
complication within that 90-day
window, compared with 26 percent
of the patients diagnosed with viral
pneumonia.
Source ; https://www.livescience.com/64061-bacterial-pneumonia-heart-health.html
Drug & Poison
Information Center
BULLETIN
January – March 2009
Drug and Poison Information Bulletin 2
Medical News (cont..)
First, the researchers allowed the mice to explore the maze to familiarize themselves with its layout, and then they
blocked a pathway before reintroducing the mice to the labyrinth. These particular mice failed to analyze the new
barricade and instead tried to go through the maze as if it was the way it had always been. C. Ronald Kahn author
reported that this is the first study that shows a relationship between these disrupted pathways and cognition
problems. Also author sated that since these two receptors can partially compensate for one another, what we did
that was critical was this combined insulin and IGF receptor knockout. However the author also reported that it was
also important to do it in specific regions, since if it was everywhere it might have impaired brain development. By
knocking out both [receptors], we removed not only the primary way they work but the backup system that's already
built in.
Alzheimer's is not a normal part of aging
Alzheimer's disease is the most common cause of dementia, which is when a person is experiencing memory loss
and other cognition issues that are severe enough to interfere with daily life. Alzheimer's, though, is not a normal
part of aging, and while most of those who have it are 65 years of age and older, it can affect people who are younger.
Alzheimer's does not get better over time, and, in most cases, it tends to worsen until the person loses the ability to
carry on a conversation or respond to what is happening around them. There is no cure for the condition, but there
are treatments available that can slow down progression and may improve the individual's overall quality of life.
There are risk factors that scientists have associated with developing Alzheimer's disease. There are some factors
that people cannot control, for example, age, family history, and genetics. People might be able to influence other
potential causes, however, including head injuries and heart disease. Other conditions that can lead to vascular
damage, such as high blood pressure and stroke, may also be factors in Alzheimer's risk.
Diabetes is also a risk factor
Additionally, diabetes is a known risk factor for Alzheimer's disease. Other studies have shown a connection between
insulin pathways and premature cognitive decline, dementia, depression, and anxiety. Also, studies have helped
demonstrate that abnormal receptors are present more often in those who have both Alzheimer's and type 2 diabetes.
The current study is the first to target specific regions to help determine cause and effect. Next, the researchers want
to look at what happens when they cross the mice they used in this study with mice that are genetically prone to
developing Alzheimer’s. Investigating these connections, they say, may lead to recommendations of lifestyle
changes well before a disease process even begins. With diabetes and obesity, there is resistance in these pathways
and, therefore, we think that this could be an important factor as to why people with Alzheimer's disease and diabetes
have a faster-accelerated course or have more Alzheimer's disease.
Reference; Available at https://www.medicalnewstoday.com/articles/324458.php.
Medical News (cont..)
Diabetes and hypertension drug combo kills cancer cells
New research, published in the journal Cell Reports, states that a drug combination that kills cancer cells by depleting
them of energy. Metformin is a common drug in the fight against type 2 diabetes. It lowers blood sugar by slowing
the release of glucose from the liver and the absorption of sugar from food in the gut. Recently, scientists have
brought more uses of the drug to light. Physicians prescribe metformin to help treat polycystic ovary syndrome, and
some researchers have suggested that the drug may improve fertility and help regulate menstrual cycles. Some have
even suggested that metformin may improve longevity. Animal studies have found that the drug may influence the
metabolic processes associated with aging and age-related conditions, and clinical trials of metformin's effects on
human lifespan are currently under way. Around 2 years ago, researchers from the University of Basel in Switzerland
found that metformin, in combination with a blood pressure drug, can stop cancer tumors from growing.
In new research, scientists now show how this drug cocktail works: the combination of metformin and the
antihypertensive syrosingopine cuts off cancer's energy supply, resulting in the death of cancer cells.
Cutting off the energy supply of cancer cells
In order to keep the energy-generating machinery running, NAD+ must be continuously generated from NADH
adding both drugs such as metformin and syrosingopine prevent the regeneration of NAD+, but in two different
ways. Many cancer cells rely on glycolysis in their metabolism, which means that they break sugar down into lactate.
When there is too much lactate, however, glycolytic pathways are blocked. So, to avoid this, cancer cells dispose of
lactate via special transporters, and this is where the drug combination comes in. this study concluded that
syrosingopine efficiently blocks the two most important lactate transporters and thus, inhibits lactate export. High
intracellular lactate concentrations, in turn, prevent NADH from being recycled into NAD+. Metformin, meanwhile,
blocks the second of the two cellular pathways that help NAD+ regenerate. So, when metformin is combined with
syrosingopine, NADH can no longer be recycled into NAD+. This, in turn, creates an energy shortage. The energy
shortage ultimately leads to the death of cancer cells, which no longer have an energy supply. The combination of
the two drugs, therefore, "may prove a viable anticancer strategy," conclude the researchers.
Reference; https://www.medicalnewstoday.com/articles/324006.php.
3 Drug and Poison Information Bulletin
Cutting off the energy supply of cancer cells
The dose of metformin for treating diabetes is not enough to stop
tumors from growing. However, adding the blood pressure drug into
the mix boosts metformin's anticancer effects. The process start as
Cancer cells need a lot of energy to grow and spread as fast as they do.
However, an obstacle in the way of cancer's metabolic needs is a
molecule called NAD+. This molecule turns nutrients into energy.
Drug and Poison Information Bulletin
Pharmaceutical Authorities News
Opioids Don't Really Do That Much for Chronic Pain, Meta-Analysis
Finds
A study that draws on data from more than 100,000 people finds a link between diabetes and an increased risk of
osteoporosis, osteoarthritis, and rheumatoid arthritis. In the United States, over 100 million people are living
with diabetes and prediabetes. Type 2 diabetes is a chronic condition requiring lifelong management; the disease
impacts a number of systems in the body.
Once the investigators had controlled for risk factors, such as age, gender, and BMI, a significant pattern still
emerged. They found that people with diabetes were 33 percent more likely to have osteoarthritis; they were also
more likely to have rheumatoid arthritis and osteoporosis (the risk increased by 70 percent and 29 percent,
respectively).
Aside from these specific conditions, when compared with people without diabetes, those with diabetes were 27
percent more likely to report back pain and 29 percent more likely to have shoulder and neck pain. The particularly
pronounced relationship between rheumatoid arthritis and diabetes could be due to the presence of
chronic inflammation in both conditions. While use of steroids in the treatment of [rheumatoid arthritis also increase
the risk of the development of type 2 diabetes. The researchers demonstrated that people with diabetes who were
more active had a reduced risk of back, shoulder, and neck pain. The researchers hope that their findings might help
physicians guide their patients.
Healthcare professionals should make patients with diabetes aware that regular exercise is a recognized treatment
for diabetes and arthritis, and can have positive effects on both blood sugar control as well as musculoskeletal pain.
It is important to note that this study was observational, so cause and effect cannot be picked apart. There may be
risk factors that these conditions share that we do not yet understand. Also, as the authors explain, the data they used
are based on participants' self-reports, which makes them considerably less reliable.
Source; htps://www.medicalnewstoday.com.
4 Drug and Poison Information Bulletin 4
The results were presented at the European Association
for the Study of Diabetes Annual Meeting, held in Berlin,
Germany. In order to investigate, the scientists took data
from the 2013 Danish National Health Survey; in all, they
had access to the records of 109,218 people aged 40 or
older. Of these people, 8.5 percent were diagnosed with
diabetes; also, they were more likely to be male, older,
and have a higher body mass index (BMI).
Medication Safety Updates
5 Drug and Poison Information Bulletin
Aspirin Can Help Your Heart. Omega-3s Might. But Together? Maybe
Not
Senior author Robert Block, stressed the levels of omega-3 fatty acids in the blood might change the effects that
aspirin can have on heart health. Doctors often prescribe daily, low-dose aspirin for people at risk of heart attacks.
This is because the medicine acts an anti-coagulant and can help prevent blood clots. And omega-3s are thought to
help reduce the risk of heart disease, though a major trial called the VITAL study, also presented at the AHA
conference, found that omega-3s may have less of an impact on heart health than previously thought.
The fish-oil factor
In this new study, Block and his team turned to a much larger database called the Framingham Heart Study, which
dates back to 1948. Here, they looked at the association between the number of people in the study who took aspirin
daily and those who had a heart attack, stroke or some other cardiovascular event in the 30-plus follow-up years.
Once the investigators adjusted for factors such as age and heart disease risk, they found that people who took
aspirin daily and also consumed a low-dose of omega-3s had around a two-fold increased risk of developing heart
disease, compared with those who took neither substance.
A low dose of omega-3s meant that of all the fatty acids in the individual's blood, 4.2 to 4.9 percent were omega-
3s. This very specific amount translates to around one tuna sandwich a week. The study also found that people who
didn't take aspirin but consumed that same low amount of omega-3s had a 55 percent lower risk of heart disease,
than those who didn't take any omega-3s. But the researchers didn't see a link between aspirin and omega-3 for
more or less than that amount of fatty acids. So, to sum up the findings: Aspirin plus a small amount of omega-3s
was associated with a slightly increased risk of heart disease. A small amount of omega-3s plus no aspirin was
associated with a lower risk.
The odd effects may arise because aspirin and omega-3s work on the same molecular pathway, Block said. So,
whether or not people should take aspirin could depend on how much seafood the person eats or how much fish oil
they take. But it could also depend on genetic factors that can change the way aspirin and omega-3s are metabolized.
Reference; https://www.livescience.com/
The effects of omega-3s on heart health, also aspirin use was
established by author block. In 2015, Block published a small
study done on 30 participants, which investigated what
happens in the blood when people take aspirin and fish oil
together. The researchers had found that at moderate levels of
omega-3s in the blood, this combination would affect platelets
cells that play an important role in blood clotting but also lead
to dangerous blockages in blood vessels.
Medication Safety Updates
FDA Approves Sympazan (clobazam) Oral Film for Adjunctive Treatment of
Seizures Associated with Lennox-Gastaut Syndrome
Nov. 2, 2018 Aquestive Therapeutics, Inc. (NASDAQ: AQST), a specialty pharmaceutical company, announced
that the U.S. Food and Drug Administration (FDA) approved Sympazan™ (clobazam) oral film for the adjunctive
treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients 2 years of age or older. Sympazan
is the first and only oral film FDA-approved to treat seizures associated with LGS. Previously, clobazam was
marketed as ONFI® and offered in two formulations – either tablet or oral suspension. It is berry flavored and
offered in 5 mg, 10 mg, and 20 mg dosages to meet a range of LGS patient and caregiver needs. Potentiation of
Sedation from Concomitant Use with Central Nervous System (CNS) Depressants Sympazan has a CNS depressant
effect. Caution patients and/or caregivers against simultaneous use with other CNS depressants or alcohol as the
effects of other CNS depressants or alcohol may be potentiated.
Source; https://www.drugs.com/newdrugs/fda-approves-sympazan-clobazam-oral-film-adjunctive-seizures-associated-
lennox-gastaut-syndrome-4858.html.
FDA Approves Tolsura (SUBA®-itraconazole capsules) for the
Treatment of Certain Fungal Infections
The US Food and Drug Administration (FDA) approved the New Drug Application (NDA) for Tolsura™ (SUBA®-
itraconazole) 65mg capsules. Tolsura is a new formulation of itraconazole indicated for the treatment of certain
systemic fungal infections in adult patients. Tolsura is indicated for the treatment of blastomycosis (pulmonary and
extrapulmonary), histoplasmosis (including chronic cavitary pulmonary disease and disseminated, non-meningeal
histoplasmosis) and aspergillosis (pulmonary and extrapulmonary, in patients who are intolerant of or who are
refractory to amphotericin B therapy). These serious infections most commonly occur in vulnerable or
immunocompromised patients, for example, those with a history of cancer, transplants (solid organ or bone marrow),
HIV/AIDS, or chronic rheumatic disorders, and are often associated with high mortality rates or long-term health
issues. Co-administration with certain drugs that either affect metabolism of itraconazole or whose metabolism is
affected by itraconazole. Hypersensitivity to itraconazole. Most common adverse reactions (incidence ≥ 1%) are
nausea, rash, vomiting, edema, headache, diarrhea, fatigue, fever, pruritus, hypertension, abnormal hepatic function,
abdominal pain, dizziness, hypokalemia, anorexia, malaise, decreased libido, somnolence, albuminuria, impotence.
Source;https://www.drugs.com/newdrugs/fda-approves-tolsura-suba-itraconazole-capsules-certain-fungal-
infections-4882.html.
6 Drug and Poison Information Bulletin
العربية الصفحة
Drug and Poison Information Bulletin 7
الهيئة العامة للغذاء والدواء . المصدر:
"الغذاء والدواء" تلغي وتعلّق مستحضرات دوائية لعدم مطابقتها للمعاير الفنية
19/01/1440
المستحضرات الدوائية، لعدم مطابقتها للمعايير الفنية وعدم تكافئها حيوياً قررت الهيئة العامة للغذاء والدواء إلغاء تسجيل مستحضر دوائي، وتعليق تسجيل عدداً من
.مع المستحضر المرجعي
الت من جميع وخاطبت الهيئة الجهات الصحية المعنية إليقاف استخدام تلك المستحضرات في حال وجودها لديها، كما ألزمت وكالء المستحضرات بسحب التشغي
.الجهات المستفيدة
الغذاء والدواء" أن لجنة تسجيل شركات ومصانع األدوية ومنتجاتها اتخذت قرارات بخصوص سحب وتعليق وإلغاء عدد من المستحضرات، شملت وأوضحت "
برقم تسجيل (Angiotec 10 mg Tablet)( و00-171-31برقم تسجيل ) (Angiotec 5 mg Tablet) سحب وتعليق تسجيل جميع التشغيالت من مستحضر
، وكذلك جميع التشغيالت من (JPM) ( وتنتجها الشركة األردنية إلنتاج األدوية00-171-33برقم تسجيل ) (Angiotec 20 mg Tablet)( و32-171-00)
Lipomax )( و07-370-35برقم تسجيل ) (Lipomax 20 mg F.C Tablet)( و07-370-36برقم تسجيل ) (Lipomax 40 mg F.C Tablet) مستحضر
10 mg F.C Tablet) ( مع المستحضر 07-370-34برقم تسجيل ً ( وتنتجها الشركة السعودية اليابانية للمنتجات الصيدالنية )ساجا(، وذلك لعدم تكافئه حيويا
.المرجعي
تجه مصنع الخليج ( الذي ين02-186-161برقم تسجيل ) (Dialon 500 mg F.C Tablet) كما تضمنت القرارات سحب جميع التشغيالت من مستحضر
.ي(للصناعات الدوائية )جلفار(، بسبب عدم مطابقة المستحضر للمعايير الفنية )فشله في اجتياز تحليل الذوبانية المقارنة بالمستحضر المرجع
نع الخليج للصناعات (، وينتجه مص10-186-279الذي يحمل رقم التسجيل ) (Glymide 5 mg Tablet) وإضافة إلى ذلك، ألغت الهيئة تسجيل المستحضر
.هـ25/10/1439الدوائية )جلفار( الذي سبق سحبه وتعليق تسجيله بناًء على قرار اللجنة الصادر بتاريخ
.وأشارت الهيئة إلى وجود بدائل مسجلة للمواد العالجية نفسها، داعية إلى مراجعة الطبيب المعالج أو الصيدلي لمعرفة تلك البدائل
، أو ٨٠٠٢٤٩٠٠٠٠لكين إبالغ المركز الوطني للتيقظ والسالمة الدوائية عند حدوث أي أعراض جانبية لألدوية عن طريق: الرقم المجاني: وأهابت الهيئة بالمسته
https://ade.sfda.gov.sa، أو الرابط: [email protected]، أو البريد االلكتروني19999، أو الرقم المّوحد: ٠٠٩٦٦١١٢٠٥٧٦٦٢الفاكس:
الهيئة العامة للغذاء والدواء .المصدر:
Editor-in-chief:
Mohamed N. Al-Arifi, PhD
Professor of Clinical Pharmacy
Director of Drug & Poison Information Center
Editors:
Abdulaziz M. Alhossan, PharmD, MPH, BCPS
Sultan M. AL-Ghadeer, PharmD, BCPS
Yazed S. AL-Ruthia, BS.C Pharm, PharmD, PhD
Drug & Poison Information Specialist’s
Salmeen D Babelghaith, PhD
Syed Wajid Ali, M. Pharma,
Rayyan A AL-Mansour, Higher Diploma.
Address / Correspondence:
Drug & Poison Information Center, College of
Pharmacy, King Saud University. P.O. Box
2457 Riyadh 11451, Saudi Arabia. Tel:
4677352, 4677353, 4677354 Fax: 4676229
E-mail: [email protected]
Feb 28-March 01, 2019 International
Conference on Bio-Pharmaceuticals
Theme: Novel Strategies and Innovations in
Pharmaceutical sciences, Osaka, Japan.
March 1-2, 2019. 24th International meet on
Pharmaceutical Biotechnology 2019.
Theme: “Providing a global platform to
explore and enhance the future of medicine
and pharmaceutical biotechnology. Paris,
France
March 18-19, 2019. 2th International
Conference on Pharmacoepidemiology and
Clinical Research. Theme: Broaden the
possibilities for Policy, Education, and
Advocacy in the field of
Pharmacoepidemiology and Clinical
Research, Dubai, UAE.
Upcoming Conferences
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