Vitamin D Supplements

The July 28th issue of The New England Journal of Medicine included results from a large, randomized, placebo-controlled trial of vitamin D supplementation to lower the risk of fractures in middle-aged and older adults who were not selected based on gender, vitamin D deficiency, low bone mass, or osteoporosis. Supplementation with vitamin D3 2000IU/day did […]

Mifepristone

The recent Supreme Court decision overturning Roe v. Wade has heightened interest in the use of the oral antiprogestin mifepristone (Mifeprex) for termination of intrauterine pregnancies. Mifepristone binds to progesterone receptors and increases prostaglandin levels by inhibiting prostaglandin dehydrogenase; both actions stimulate uterine contractility. It is generally used with the prostaglandin analog misoprostol (Cytotec, and […]

Overdose-Prevention Centers

The May 26 issue of The New England Journal of Medicine includes 2 articles on a subject that deserves more attention than it has received from us.1,2 Drug overdose deaths rose above 100,000 annually during the Covid-19 pandemic in the US, fueled at least partly by purposeful fentanyl contamination of illicit drugs. Naloxone is widely […]

Whither COVID-19?

Or, in modern English, where is this pandemic going? The answer is clear: we don’t know. In Shanghai 26 million people have been locked down in their homes, while in Florida the governor is imploring children to take off their masks. CDC.gov tells us that more than 982,000 Americans have died from COVID-19, more than […]

Oral Antivirals for COVID-19: Supply and Demand

In December, the FDA granted Emergency Use Authorizations (EUAs) to 2 oral antiviral drugs for treatment of mild to moderate COVID-19 in outpatients at high risk of progressing to severe disease, including hospitalization or death. The long list of conditions that qualifies infected patients for a prescription for one of these agents includes age >65 […]

Remdesivir for Outpatients, At Last

An article in last Sunday’s New York Times described the 7-hour search of a Times reporter who lives in Washington state for Paxlovid, the new Pfizer drug for oral treatment of COVID-19. Her elderly mother with risk factors living in northern California had just developed early symptoms of the disease and a positive at-home coronavirus […]

Looking Ahead: An Effective Oral Drug for Treatment of COVID-19

The three worst pandemics in known human history were the bubonic plague in the 14th century, influenza in 1918, and the acquired immune deficiency syndrome (AIDS) that was first recognized in 1981. Influenza killed 50 million people, AIDS has killed 35 million, and COVID-19 has killed about 5 million, so far. Now it appears that […]