My Statin Comes From India

According to the USP, the bulk of the APIs come from India. That country is responsible for 50% of the active pharmaceutic ingredients. China is not far behind at 32%. The European Union supplies 10%. That’s a big change since 2000. Back then, European countries like France, Germany, Switzerland and Denmark supplied 42% of the APIs. Drug Recalls From India – Can You Trust Foreign-Made Generics?https://www.peoplespharmacy.com/articles/more-drug-recalls-from-india-do-you-trust-foreign-made-generics

Dozens of companies received approval from the FDA over the years to sell metoprolol and bupropion in the U.S. Yet from 2018 to 2024, the agency reported running only 2 tests on metoprolol and 7 on bupropion through its quality surveillance program — in each case, by pulling a sample from a single drug maker. In many of those years, the drugs weren’t tested at all, FDA records show. Those that were assessed received passing results. The FDA Often Doesn’t Test Generic Drugs for Quality Concerns, So ProPublica Didhttps://www.propublica.org/article/fda-generic-drug-testing

ClinCalc DrugStats Databasehttps://clincalc.com/DrugStats/

Both articles are long reads but worth your time.

Yikes.

Ketamine in the UK

Acute harms of ketamine use relate to vulnerability and injuries. Long term use can seriously harm both physical and mental health, diminishing quality of life, affecting personal relationships, and impairing academic or professional performance.9 Ketamine induced uropathy from ulceration and thickening of the bladder is a common and serious complication. In the UK, 27% of regular ketamine users report at least one urological symptom—dysuria, frequency, incontinence, haematuria, or retention—with severity correlated with dose and frequency of use.10 Treatment requires abstinence.11 If abstinence is not achieved, irreversible bladder and kidney damage can occur, requiring urinary tract reconstruction. Long term ketamine use is also associated with “K cramps”—severe abdominal pain. This may be related to liver disease that is similar to primary sclerosing cholangitis but less inflammatory and progressive.12 Acute harms of ketamine use relate to vulnerability and injuries. Long term use can seriously harm both physical and mental health, diminishing quality of life, affecting personal relationships, and impairing academic or professional performance.9 Ketamine induced uropathy from ulceration and thickening of the bladder is a common and serious complication. In the UK, 27% of regular ketamine users report at least one urological symptom—dysuria, frequency, incontinence, haematuria, or retention—with severity correlated with dose and frequency of use.10 Treatment requires abstinence.11 If abstinence is not achieved, irreversible bladder and kidney damage can occur, requiring urinary tract reconstruction. Long term ketamine use is also associated with “K cramps”—severe abdominal pain. This may be related to liver disease that is similar to primary sclerosing cholangitis but less inflammatory and progressive.12Non-prescribed ketamine use is rising in the UKhttps://doi.org/10.1136/bmj.r1167

Yikes.

Update 07.05.25https://www.bbc.com/news/articles/c70r1xdyy59o

Scary Charts 12.01.24

Office CMBS Delinquency Rate Spikes to 10.4%, Just Below Worst of Financial Crisis Meltdown. Fastest 2-Year Spike Everhttps://wolfstreet.com/2024/11/30/office-cmbs-delinquency-rate-spikes-to-10-4-just-below-worst-of-financial-crisis-cre-meltdown-fastest-2-year-spike-ever/

Yikes.

The world’s worst countries for binge-drinking https://www.statista.com/chart/5357/the-worlds-worst-countries-for-binge-drinking/

Yikes.

Which Lifestyle Changes Can Make You Live Longer?https://www.statista.com/chart/31766/reduction-in-the-risk-of-premature-death-after-age-40-when-sticking-to-the-lifestyle-factors/

Yikes.

The Worst U.S. States For Binge Drinkinghttps://www.statista.com/chart/12345/the-worst-us-states-for-binge-drinking/

Yikes. But a great day for Scary Charts!

Fentanyl Facts

In 2022, according to provisional data from the Centers for Disease Control and Prevention (CDC), close to 83,000 people died from opioid overdoses in the United States, the majority from fentanyl and other highly potent synthetic substances. A Yale Medicine addiction medicine specialist discusses how the synthetic opioid became a problemhttps://www.yalemedicine.org/news/fentanyl-driving-overdoses

Meanwhile in Oklahoma…

Go here https://facingfentanylnow.org/fentanyl-facts/ for the facts.

The Latest in COVID-19 News: Week Ending 04.24.21 – NEJM Journal Watch

Click on the link for the NEJM Journal Watch weekly update.  Not a lot of links this week for SARS-CoV-2 articles but again I did not forget to post this.

https://www.jwatch.org/fw117733/2021/04/24/covid-19-news-week-ending-apr-24-2021

So in the spirit of big news that didn’t get mentioned in this week’s NEJM Journal Watch:

FDA, CDC Lift Suspension of Johnson & Johnson Vaccine

Cite this: FDA, CDC Lift Suspension of Johnson & Johnson Vaccine – Medscape – Apr 23, 2021 — https://www.medscape.com/viewarticle/949913

Meanwhile pray for India.

India has recorded nearly a million infections in three days, with 346,786 new cases overnight into Saturday.

India Covid surge: Hospitals send SOS as record deaths registered — https://www.bbc.com/news/world-asia-56870410

What is driving the second wave in India? — Science Chronicle

Understanding the infectiousness of the double mutant variant becomes all the more important as noncompliance to COVID-19 appropriate behaviour is uniformly poor across India. Yet, the surge in cases is seen only in 19 States, and mainly in about a dozen States. In the absence of timely results of such studies, which will help policy […]

What is driving the second wave in India? — Science Chronicle

Just the use of the phrase “double mutant variant” sends chills up my spinal cord.