What Most Highly Prescribed Chemotherapy Drug For Cancer Is Extracted From A Tree Bark?

Taxol is a chemotherapy drug used in the treatment of specific human cancers. It is a member of the taxane family of drugs, which includes cabazitaxel and docetaxel.

The drug is also sold under its generic name of paclitaxel (pronounced pack-lee-tax-elle). Taxol is available by prescription only and is administered via an intravenous injection in a hospital setting. The dose each patient is administered is calculated taking into account their underlying health, height and weight.

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History

Arthur Barclay was a botanist working for the US Department of Agriculture in the 1960s. Under contract to the US National Cancer Institute, Barclay collected samples of plants to find new drugs.

The National Cancer Institute screened 35,000 plants. One particular sample Barclay collected, the bark of the Pacific Yew tree, went on to provide what is now one of the most highly prescribed chemotherapy drugs for cancer.

Taxol, which is a chemical extracted from the bark, was selected for commercial development in 1977 and was first tested in patients in 1984. It was approved for use by the US Food and Drug administration in 1992 and by 2000 had annual sales of A$2.1 billion per year.

The drugs name is derived from the Latin term for the tree, Taxus brevifolia.

How It Works

Every cell in the body has long rod-like structures, which scientists call microtubules. These microtubules have several functions, one of which is to act like a type of skeleton structure that helps give cells their shape.

When cells replicate, they break down this skeleton, divide into two cells, then rebuild it. Taxol acts by promoting the formation of these microtubules, which means they get in the way when the cells try to divide.

Preventing cells from replicating sends them into a process of programmed cell death called apoptosis, which kills the tumour.

Who Is Administered Taxol?

Taxol is used in combination with other chemotherapy drugs and surgery. In Australia, it is used to treat ovarian, breast, cervical, endometrial and non-small cell lung cancers.

It is also used to treat AIDS-related Kaposis sarcoma, a rare type of cancer that develops as tumours on the skin and inside the mouth.

Problems With The Drug

The biggest problem of Taxol is its poor solubility in water. Water solubility is important because a drug must be fully dissolved to be safe for injection. Any solid particles in an intravenous injection can lead to blood clots and inflammation of the veins.

Because of this, Taxol is typically dissolved in alcohol with the addition of a soap-like chemical called polyoxyethylated 35 castor oil (also referred to as Chremophor EL).

A new formulation of protein-bound Taxol called abraxane is available in Australia. In this formulation, Taxol is combined with albumin, the most abundant protein in human blood serum. Binding the drug to the protein makes it take on the albumins solubility, and it can then be administered to patients in water-based formulations.

Controversy

The Pacific Yew tree grows only in the northwest region of America. It is slow growing and found only in old-growth forests.

In the early days of the drugs development, the bark was obtained from the tree by logging, which killed the trees. This meant supply of the drug was limited and the process was nonrenewable and not environmentally friendly. At least one kilogram of bark was required to produce just 10 grams of drug.

Thankfully, while the drug cannot yet be completely synthesised in a factory, chemists have developed ways to produce it using precursor chemicals found in the needles of a related tree, Taxus baccata.

They can also manufacture the drug by culturing plant cells. This latter process is renewable and can produce up to 50 grams of drug per kilogram of plant material.

Side Effects

Like all chemotherapy drugs, Taxol has some common side effects, which many patients experience. These include the production of fewer blood cells, which can make patients anaemic and susceptible to infections; nausea; vomiting; diarrhoea; hair loss; muscle and joint pain; nerve problems, which include weakness, tingling, pain or numbness in the hands or feet; and changes in heart rate and blood pressure.

These side effects can be managed by giving the patient additional medicines or by adjusting the dose of the drug.

Taxol also has another side effect that can be life-threatening. Some patients experience a severe allergic reaction the first time they are given the drug. This is due to the Chremophor EL included in the formulation.

In these cases, the doctor may give the patient a different taxane drug, use albumin-bound Taxol instead, or develop a plan to desensitise the patient to Taxol.

Cost

Whether a patient is charged for this drug depends on how the hospital classifies them. Anyone classified as a public in-patient will be not be charged for Taxol as its cost will be covered under Medicare.

Anyone classified as a public out-patient will be charged at a maximum rate of A$38.30 per treatment.

Under a special arrangement, the price the government pays for the albumin-bound formulation of Taxol depends on the type of cancer it is being used to treat and costs between A$1,287 to A$2,562 for 275 mg of the drug.

In contrast, the normal Taxol formulation is much cheaper, although less safe, for the government at A$222.90 for 450 mg of the drug.

Information provided in this article is based primarily on the Australian Medicines Handbook 2016. If you would like more information, the patient information sheet on Taxol is available here.

 

Nial Wheate, Senior Lecturer in Pharmaceutics, University of Sydney

Read more: http://www.iflscience.com/health-and-medicine/weekly-dose-taxol-anticancer-drug-discovered-bark-tree

New Research Reveals Hydromorphone Effective For Treatment of Heroin Addiction

Hydromorphone, an injectable treatment, could be effective for chronic opioid addictions for which traditional methods have not worked, new research found

A licensed pain medication could be used as an effective treatment for chronic heroin addiction, according to new research.

The results of a multi-year clinical trial testing alternative treatments for heroin addiction published on Wednesday provide another option for addictswho have found traditional treatment to be ineffective, the researchers said.

Today, we have made tremendous progress, said the studys principal investigator, Dr Eugenia Oviedo-Joekes.

Oviedo-Joekes said that hydromorphone, a narcotic pain medication, was a new tool available to fight opioid addictions for some patients. Many people with opioid addictions are treated with methadone and buprenorphine. The research released on Wednesday suggests an accessible alternative for patients for whom methadone and buprenorphine have been ineffective, estimated to be roughly 10% of the heroin-dependent population.

Hydromorphone is an injectable treatment and can be more effective for long-term heroin users, the researchers said.

The Study to Assess Longer-term Opioid Medication Effectiveness (Salome) was started in 2011 by researchers from Providence Health Care and other public health organizations in Vancouver. The Salome study was launched as a successor to previous research which found injectable, prescription heroin to be a more effective treatment than methadone. The Salome study found hydromorphone to be equally effective as prescription heroin. Injectable diacetylmorphine, as prescription heroin is known, is a controversial treatment option in some countries, including Canada and the US, but is used regularly in multiple other countries including the United Kingdom and Germany.

Daniel Wolfe, a director with the human rights group Open Society Foundations, said Salomes new research could help move North America past its ideological bias against injectable treatments.

The importance of this study is that it shows that we have a medicine thats already available that could be an effective treatment for that small group of patients from the other more commonly available treatments, he said.

Hydromorphone is a pain reliever and not currently approved to treat addiction. Dr Melinda Campopiano, a medical officer with the Substance Abuse and Mental Health Services Administration, said the study was promising but that she wasnt sure that this study has a lot to offer right now.

The research is exciting, but we have existing treatment thats not being made available, so thats our bigger problem, she said.

Most organizations fighting drug abuse say that treatment for addiction should include medication when available, in conjunction with therapy and other treatments.

Officials in the US have redoubled efforts to address heroin addiction in recent years. Heroin-related overdose deaths nearly quadrupled in the US between 2002 and 2013, according to the Centers for Disease Control and Prevention. Opioids were related to at least 28,647 deaths in 2014, according to the organization.

Max, a participant in the study, spoke at a press conference in Vancouver and recommended the treatment to addicts for whom alternatives havent worked. Max, who identified himself only by his first name, said that before participating in the study, he had been homeless and resorted to criminal activity to pay for his heroin habit.

Yesterday was my 50th birthday. I didnt think Id ever hit 50, he said. Its done wonders for me and I know that its going to help a lot of people in the future. I give it all my recommendations.

Read more: http://www.theguardian.com/world/2016/apr/07/pain-medication-heroin-addiction-alternative-treatment

Hay Fever Drugs That May Increase Risk Of Dementia In The Elderly

As anyone that suffers from it will know, hay fever is nothing short of profoundly irritating. Fortunately, there are a range of prescription and over-the-counter drugs you can take to remedy the problem, but as a new study shows, some of them may be causing some particularly unfortunate neurological side effects.

As revealed in the journal JAMA Neurology, a class of drugs known as anticholinergic medication which includes treatments for hay fever, colds, and high blood pressure are linked to shrinkage of the brains of those around retirement age. Although a direct causal link cannot yet be demonstrated, there is some evidence suggesting that these drugs may increase an elderly persons chance of getting dementia as they age.

These findings provide us with a much better understanding of how this class of drugs may act upon the brain in ways that might raise the risk of cognitive impairment and dementia, said Shannon Risacher, assistant professor of radiology and imaging sciences at Indiana University School of Medicine, in a statement.

In 2015, a study began to make frightening headlines that anticholinergic medications raises the risk of dementia. These drugs are easily obtainable and commonly consumed.

Published in the journal JAMA Internal Medicine, it revealed circumstantial evidence thatsuggested those over the age of 65, if taking a high dose (one pill a day, every day) for at least three years, have a 54 percent higher risk of developing dementia; 80 percent of these subjects had Alzheimers disease.

This new study was designed to find out why this may occur. The researchers observed 451 participants at pensioner age, 60 of whom were taking medication with moderate-to-high anticholinergic activity potency, for nearly a decade. At set intervals throughout observation, they were all given cognitive reasoning tests to assess their mental acuity, along with MRI brain scans.

The precise underlying neurological mechanism for these changes has not yet been found. Juan Gaertner/Shutterstock

Those on higher doses not only showed increasingly impaired mental acuity over time, but their brains showed overall shrinkage. In addition, their brains featured lower levels of glucose metabolism a proxy for brain activity throughout, but particularly in the hippocampus, the region associated with memory formation.

These drugs, a list of which can be found here, are known to block acetylcholine, an important nervous system chemical used by neurons to communicate with each other. It may be that this effect is inadvertently having these other observed effects, although this study cannot directly prove this once again, its a circumstantial link.

As with both studies, these links were not investigated for those under 65. As always, if youre thinking of changing medication based on this study, see a healthcare professional first.Suddenly stopping medication for hay fever may be vexing, but doing the same for high blood pressure tablets may prove dangerous.

Given all the research evidence, physicians might want to consider alternatives to anticholinergic medications if available when working with their older patients, Risacher added.

Its also worth stressing that an increased risk of getting dementia by 54 percent is not the same as having a 54 percent chance of developing dementia. If you are in the U.K., for example, you have about a 7 percent chance of developing dementia if you are 65, which is quite low. This percentage barely changes when the increased risk gained by taking these drugs into account.

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Read more: http://www.iflscience.com/health-and-medicine/class-common-prescription-drugs-appear-cause-brain-shrinkage-elderly

NEVER Give This OTC Medicine To A Kid With Chickenpox

Hayley recently experienced something most parents do when their kids are young: her son Lewis came down with a case of chickenpox. Several doctors prescribed children’s ibuprofen, which is an anti-inflammatory medication commonly prescribed to treat chickenpox. So, Hayley gave the meds to Lewis. After all, she thought, who are we to question a doctor’s prescription?

But Hayley was soon about to realize that while children’s ibuprofen is a perfectly normal way to treat other conditions, it’s not something that Lewis should have taken for his chickenpox. Her son’s health began to decline. Not only did Lewis’ temperature continue to rise, but the pox became severely blistered and painful.Despite the fact doctors said it was still a “normal” case of chickenpox, Hayley’s motherly instincts kicked in.

As it turned out, Lewis contracted septicaemia and was immediately admitted to Alder Hey Children’s Hospital in Liverpool. Only because Hayley persevered and took Lewis to a children’s hospital at her own accord was he able to begin the recovery process.

Now, Hayley is on a mission to warn other parents about the dangers of taking Ibuprofen to treat chickenpox. She shared the heartbreaking images of Lewis’ reaction to the Ibuprofen and laying in his hospital bed. Her post has been shared more than 430,000 times and counting. Not only that, but the Royal College of Paediatrics and Child Health has since said both parents and doctors need greater awareness of the small but significant risk ibuprofen carries in chickenpox cases.”

Scroll down to see Hayley’s warning to parents in full. Please note these images are quite shocking and may be disturbing for some viewers.

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“Chickenpox is going round again can I please remind people NOT to give your children nurofen/ibuprofen,” Hayley wrote on her Facebook page.

“4 different doctors from our local (out of hours) prescribed it for Lewis as we couldn’t get his temp down.”

“This type of medicine is an anti inflammatory, it reacts with chicken pox making them go deeper into the skin tissue.”

CLICK TO REVEAL

“It was only wen we took Lewis to Alder Heybecause the doctors from our hospital kept sending him home saying it was ‘just chicken pox’ we found this out.He ended up with septicaemia and was admitted straight to Alder Heyas soon as we arrived there.”

Symptoms of septicaemia include: sudden high fever with chills; nausea, vomiting and diarrhea; abdominal pain; shortness of breath; and rapid heart rate. It can be treated with antibiotics, but early treatment is essential.

CLICK TO REVEAL

“Only because we persevered an took Lewis to a children’s hospital off our own back was he ok. This could have ended up so much worse if it wasn’t for those doctors at septicaemiaand their advice, care and knowledge.Only use CALPOL for their temps.

It does actually state on the nurofen website not to take this medicine with chickenpox. (We discovered this after it happened) But when our doctors prescribe it, who are we to question it??”

Lewis is currently in recovery.

Meanwhile, because of Hayley’s public outcry,The National Institute for Health and Care Excellence (NICE) has recommended that ibuprofen is no longer used for chickenpox. The Royal College of Paediatrics and Child Health now saysboth parents and doctors need greater awareness of the small but significant risk ibuprofen carries in chickenpox cases.

Parents across the world are praising Hayley for speaking out in an effort tostop this from happening to any other children. “I’m so thankful to everyone for sharing the post so that something will now be done about it,” she wrote on Facebook. “These medical professionals are now going to ensure that all doctors know the risks and hopefully they’ll no longer prescribe it. I will not stop raising awareness until these types of medicines are labelled with the risks of this being prescribed to someone with Chickenpox.

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Read more: http://www.littlethings.com/ibuprofen-chickenpox-hayley/