Semaglutides - - Good for More than Weight Loss
Submitted by Barbara Daly
The past decade has shown an increasing use of the semaglutides, such as Wegovy, Ozempic, and Rybelsus. Currently there are an estimated 5.7 million people in the US taking one of the semaglutide products for weight loss. Given this, it is quite likely that nurses in all specialties will care for patients who are prescribed one of these drugs or seek prescriptions. Given the rapid and continuing research on the effects of these drugs, nurses face a challenge in keeping up with new information. In the previous “News and Views” we reported on the research that showed no association between these drugs and suicidal ideation. Here we summarize recent evidence of beneficial effects on cardiovascular risk.
Semaglutides are agonists (activators) of glucagon-like peptide (GLP-1) receptors. These receptors, normally released in response to eating, enhance insulin release, decrease glucagon release, and stimulate brain centers that reduce appetite. Rybelsus is provided in tablet form and both Ozempic and Wegovy are weekly injectables. Only Wegovy is approved for use in children over age 12 years.
Previously restricted to use only for weight loss in persons with diabetes and obesity, use of the semaglutides is undoubtedly going to increase as a result of several large trials that have shown positive effects for both cardiovascular risk and chronic kidney function. In December the New England Journal of Medicine reported results of a randomized, placebo controlled trial with 17,604 patients without diabetes. Semaglutide was associated with reductions in mortality, myocardial infarction, and stroke (SELECT Clinical trials.gov). Similarly, other large trials have shown that semaglutide use may reduce decline in kidney function, slowing the rate of decrease in glomerular function that occurs in patients with diabetes and chronic kidney disease.
Given the extensive television advertising for these drugs that currently occurs, patients who struggle with weight loss and those with concomitant diabetes are likely to ask about use of semaglutides. Nurses need to be knowledgeable about the various forms and likely side effects. In particular, it is important to be aware that the increasing demand for the drugs has led to significant shortages. This, in turn, has prompted both reliance on compounded forms, which may not have the same ingredients and are not FDA regulated or approved. Unfortunately, the shortage has also led to on-line advertising of products that are counterfeit versions of semaglutide and may produce unintended toxicities.
Tuttle KR, Bosch-Traberg H, et al. Post hoc analysis of SUSTAIN-6 and PIONEER-6 trials suggest that people with type 2 diabetes at high cardiovascular risk treated with semaglutide experience more stable kidney function compared with placebo. Kidney International 2023; 103: 772-781.
Irfan H. Obesity, cardiovascular disease, and the promising role of semaglutide: Insights from the SELECT trial. Current Problems in Cardiology 2024; 49: 102060.
DID YOU KNOW….. RSV vaccination is not just for kids!
Submitted by Barbara Daly
RSV (Respiratory syncytial virus) was formally thought to be a serious viral infection only in infants and children. We now know it presents significant risks to adults, particularly elderly. The CDC recently reported a study of 5,784 adults >age 60, hospitalized with laboratory confirmed RSV, Covid, or influenza. Patients with RSV were more likely than those with COVID or flu to receive supplemental oxygen and ICU admission than those with either COVID or flu. Patients with RSV were also more likely to require mechanical ventilation and to die than those with the flu. While RSV is less common than COVID or flu, it is associated with more severe disease in older adults. RSV vaccination should be discussed with all older adults as part of routine visits.
Primary Election Reminder
Jan Lanier JD, RN
2024 is a presidential election year; but it is also an important election at the state level. All members of the Ohio House will be up for reelection, and half of the Ohio Senate. The primary election to determine
who will be on the November ballot will be Tuesday, March 19, 2024. Many voters tend to sit out primary elections, but those elections are open where the true competition is found. This is particularly true in states like Ohio where the districts are drawn in a way that typically ensures a victory in a primary means a victory in November for whatever candidate is selected to represent the majority party in a gerrymandered district.
As always, there are important dates and deadlines to be aware of. Below is a list of such dates for Ohio in 2024.
Deadline to register to vote* Early voting starts
Deadline to REQUEST an absentee ballot
Postmark deadline for absentee ballots sent via U.S. mail ELECTION DAY
VOTING in 2024 Primary Election
- February 20, 2024
- February 21, 2024
- March 12, 2024
- March 18, 2024
- March 19, 2024
- October 7, 2024
- October 8, 2024
- October 29, 2024
- November 4, 2024
- November 5, 2024
Absentee ballots postmarked by March 18 must ARRIVE at county board of elections by March 23, 2024 for primary elections & November 9, 2024 for general elections
*Register to vote on-line at olvr.ohiosos.gov or register in person at your county board of elections, the Bureau of Motor Vehicles, public libraries, or some other sites.
For information, go to voteohio.gov.
New pill for postpartum depression
Submitted by Jan Lanier
New pill for postpartum depression
(Source: Hassanein, N. (January 11, 2024) New pill for postpartum depression but many at-risk women face hurdles. Stateline Kaiser Family Foundation Washington, D.C.)
The first pill for postpartum depression (zuralone, brand name Zurzuvae) has been approved by the United States Food and Drug Administration and it is now available to the public. However, the cost of the drug ($16,000 for the required two-week course of therapy) is likely to assure that the medication is effectively out of reach for many women.
A 2022 CDC study from 2017-2019 found that one in eight pregnant women and newly postpartum mothers experience symptoms of postpartum depression. A federal study found suicide and drug overdoses among the leading cause of pregnancy-related deaths. The women most affect are the indigenous population (31%) and Black women. Black women have a maternal death rate that is three times higher than white women, and they are two-times as likely as white women to suffer from a mental health condition; but are half as likely to get treatment.
According to the Kaiser Family Foundation, Medicaid covers 41% of Black and indigenous births yet few states’ Medicaid agencies have policies in place regarding coverage of the new drug. Requests are currently handled on a case-by-case basis. Likewise, few private insurers (.017%) have published guidelines. Most of these companies impose “fail first” requirements or require the drug to be prescribed by a psychiatrist rather than an OB/GYN. Many psychiatrists do not accept private insurance, and the shortage of both these specialists further limits the drug’s availability.
The drug’s manufacturers Biogen and Sage Therapeutics are working to increase awareness of the need to treat postpartum depression.
NCSBN Opportunities for Graduate Nursing Students
Submitted by Jan Lanier
(Source: National Council State Boards of Nursing retrieved January 14, 2024, from ncsbn.org/regulatoryscholars).
The National Council of State Boards of Nursing, headquartered in Chicago is the organization to which all state and U.S. territorial boards of nursing belong. The organization is considered the collective voice for nursing regulation and is responsible for developing and maintaining the NCLEX licensure examination and for administering the Nurse Interstate Licensure Compact. NCSBN is a regulatory resource for individuals and regulatory boards internationally.
As part of its mission to ensure regulatory excellence, NCSBN sponsors several opportunities to experience/participate in policy analysis as it relates to NCSBN’s mission. The opportunities include the following:
Scholar in Residence is an eight-week, full time, paid experience that provides a doctoral student or a faculty member with regulatory/policy experience related to education, practice, licensure, and/or discipline. The position will begin in the summer of 2024, or as negotiated with NCSBN.
Grant Program for Doctoral Students provides funding for scientific research projects related to nursing regulation and policy. Participants will have two years to complete their study. Study results will be published and presented to national and international audiences.
Unpaid Graduate Internship for nursing graduate students who would like to gain regulatory/policy experience to satisfy the clinical experience component of their program. The three-month internship will take place in Chicago and students will gain experience in a variety of NCSBN departments and contribute to the work of the organization while obtaining experience in nursing regulation.
To learn more about these opportunities, visit the NCSBN website at www.ncsbn.org/regulatoryscholars.