Dr. Nabarun Dasgupta Profile picture
Sep 17, 2020 9 tweets 9 min read Read on X
Excited for Priya Bahri’s plenary session on #scicomm at #ICPE20 #RxEpi starting at 11:15am ET today

#pharmacoepidemiology @ISPE_Exchange
Here we go! #icpe2020
"Is silence better than getting it wrong?" when it comes to emerging medication safety issues for patients - Priya Bahri asks of #drugsafety at #ICPE20
Insight from François Houyez of @eurordis : If patients are taking many meds, we may want a side effect to be caused by a particular one of them"
@eurordis François Houyez of @eurordis lays out great case study on patient panic from inadequate patient safety communication.

Also #excipient matters are very relevant to patients!

At #ICPE20 - #RxEpi
"100% increase" for RR=2 ? Wegwarth @mpib_berlin @ #ICPE20: relative scale leads thinking med/intervention is MORE effective/harmful than it is. Use carefully!
Contraceptive increased side effect 1 ➡️ 2 out of 7k = 0.01% absolute ⬆️ , 100% relative ⬆️
#EpiTwitter #RxEpi
Odette Wegwarth of @mpib_berlin @ #ICPE20 closes with: “Statistics are like a bikini. What they reveal is interesting, but what they hide is vital.”
― Aaron Levenstein

#RxEpi #SciComm
@mpib_berlin Sara ElShafie @sci_story blows up #ICPE20 with this quote from @AlanAlda @AldaCenter
Sara ElShafie @sci_story's presentation at #ICPE20 is 🔥👏

"#SciComm is distilling, not dumbing down. Most important thing is start with empathy. Audience will remember most how you made them feel."

sara-elshafie.com
#RxEpi

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More from @nabarund

Jun 7
Let's bring some science into all this talk about #medetomidine. 🧵

TLDR: Expect unexpected sedation.

We predicted it would soon emerge in illicit supply, and @US_FDA agreed, and so we have this grant to investigate its pharmacology, etc. @nanopharmNC

fda.gov/science-resear…
We first observed #medetomidine in NC in a sample collected in October 2022, in Raleigh. Combined with xylazine, and traces of fentanyl and meth. @LunaJBear
streetsafe.supply/results/p/3004…
If you've seen me present in the last year, #medetomidine has been sitting on our team's Watch List (slide 52) for awhile now.
cdr.lib.unc.edu/concern/schola…
Read 24 tweets
Sep 9, 2023
1 🚨Attention please: Turns out #xylazine is a kappa opioid. This validates experience from frontline folks and PWUD. Fresh science from collaborators @nanopharmNC @MadiganLBedard @zenbrainest
Pre-print:
Public health 🧵 below
#TwitteRx #harmreductionbiorxiv.org/content/10.110…
Check out @nanopharmNC's explainer on the lab science. I'll breakdown the #publichealth implications.
@nanopharmNC Basic pharmacology. Mu is the opioid receptor in the brain we usually talk about when we say “opioid” – but there are others. Kappa is less popular, but still very much an opioid receptor. HOWEVER, it’s NOT canonically linked to opioid euphoria.

sites.tufts.edu/opioidpeptides…
Image
Read 18 tweets
May 22, 2023
Let's talk #nalmefene for OD reversal, an old generic drug in new expensive clothes. FDA approved Rx-only nasal spray today. Will this help prevent overdose deaths in the fentanyl-xylazine-strongbenzo era?

🧵👇

fda.gov/news-events/pr…
Nalmefene was developed in the 1980s by erstwhile Key Pharma in Miami, with help from scientists at @UVA
europepmc.org/article/med/39…
It was marketed as an injectable by Baxter Pharma as Revex for alcohol dependence, initially approved in April 1995 and "discontinued on May 21, 2008, for business reasons."

federalregister.gov/documents/2017…
Read 21 tweets
Apr 12, 2023
Based on our lab data, I reckon #xylazine shows up in the drug supply 5 specific ways:
🧵👇
1. Veterinary diversion is rare, niche, and localized to interconnected Caribbean communities:

Philly


Puerto Rico
link.springer.com/article/10.118…
2. Most commonly... Fentanyl and #xylazine in combo, about 3:1.

We don't see xylazine-related synthesis impurities but do see fentanyl impurities, so our hypothesis is that xyl is being added intentionally in pure form.
Example from Lexington NC: streetsafe.supply/results/p/3003…
Read 14 tweets
Feb 15, 2023
Y'all ready for this? 🍿👊
#NarcanAdCom about to pop off
Use this # to follow today's updates

CONCEPT
The culmination of 2 decades of advocacy to make naloxone OTC

REALITY
2 decades of advocacy erased by overdose crisis profiteers $EBS

Right out the gate, FDA frames this as a solution for saving kids from overdose. Guess that’s why there are so many pediatric anesthesiologists on the AdCom
In the review of the history FDA forgets to credit the people (like Dan Bigg) who invented the intervention
Read 53 tweets
Sep 23, 2022
🚨 Something huge happened today. 🚨

@US_FDA @DrCaliff_FDA listened to harm reduction programs and made it infinitely easier to purchase #naloxone in bulk. With 100,000+ overdose deaths each year, we need BIG solutions.

w/@RemedyAlliance @ejwheeler9 @coreysdavis
🧵 1/26
@US_FDA @DrCaliff_FDA @RemedyAlliance @ejwheeler9 @coreysdavis The FDA Guidance provides clear federal support for bulk purchase and distribution of naloxone to meet one of the biggest public health challenges of our times.

Full text via link below, but let's break it down.


2/26
@US_FDA @DrCaliff_FDA @RemedyAlliance @ejwheeler9 @coreysdavis This is a watershed moment. Along with low-cost naloxone available through @RemedyAlliance and state standing orders, this Guidance establishes a trifecta of innovations that will help rapidly scale up naloxone distribution.
3/26
Read 33 tweets

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