16 | wphospitalnews.comIssue No. <strong>10</strong>New Molecules May Reduce Risks of Respiratory DepressionBy Mark A. VarneyOpioids are drugs thatmimic the effects of opiumand can be used to treat severepain. Unfortunately,they are highly addictive,and they contribute to thefact that prescription drugabuse is the fastest-growingdrug problem in the US.Prescription drug addictionis now killing more peoplethan crack cocaine in the 1980s and heroin in the1970s combined. As a result, in late April, the Obamaadministration unveiled its Prescription Drug AbusePrevention Plan, which orders that health careproviders learn appropriate uses for opioids beforethey can get a license to prescribe them. Congressmust now decide whether to amend the ControlledSubstances Act to incorporate the plan.FDA Commissioner Margaret Hamburg has saidthat the opioids—including OxyContin and nearly adozen other painkillers—are widely misprescribedand abused. Their destructive effects were starklyoutlined in an April 19 New York Times article, profilingthe devastation wrought upon smaller communitiessuch as Portsmouth, Ohio. Many young peoplein rural towns gain access to the drugs from dealersand users with access to prescriptions. Across Ohio,fatal overdoses have quadrupled in the last decade.Statewide, more people died from prescription drugoverdoses in 2008 and 2009 than the number of peoplewho died in the World Trade Center attacks onSeptember 11, 2001.The opioids work by attaching to specific receptorsin the brain and blocking the perception of pain; overtime, they can cause physical and chemical changes inthe brain’s pathways. Taking too much of an opioidcan cause breathing to slow—a phenomenon knownas respiratory depression—and, in some cases, stopentirely. As abuse of these drugs has grown, so hasthe number of overdoses.A 2009 paper in the journal Anesthesiology detailedhow AMPAKINE® CX717, a compound inclinical development created by an Irvine, California-basedneuroscience company Cortex Pharmaceuticals,rescued fentanyl-induced respiratorydepression in rats. These studies supported testingthe AMPAKINE in human volunteers, and in thesestudies, Cortex was able to show that CX717 preventedthe onset of respiratory depression by an opioid.“Patients are usually given an opiate to mediatepain during surgery,” explains University of Albertaprofessor Dr. John J. Greer, who led the animalstudy. “The study’s hypothesis was that the AM-PAKINE molecule can stimulate breathing withoutinterfering with the beneficial analgesic effects ofopioids.”In this study, CX717 demonstrated equal efficacywith the opioid-antagonist Naloxone, a drug used tocounter the effects of opioids on suppression of breathing.CX717 did not, however, interfere with the actionof pain-killing opiates. This offers a distinct advantagecompared with Naloxone and could provide a noveltherapeutic means of treating those patients who areparticularly prone to breathing depression with opiateswhile achieving maximum pain relief.This is also significant because drug-induced respiratorydepression enhances the risk of sleep apneaor exacerbates this condition in those who alreadyhave it. In turn, sleep apnea has been shown to contributeto heart disease; last year, a study led by Dr.Daniel Gottlieb at Boston University School of Medicinefound that men between the ages of 40 and 70who have severe sleep apnea are 68 percent morelikely to develop heart disease, and 58 percent morelikely to develop heart failure, than those without thecondition.AMPAKINE compounds act on the most commonexcitatory receptor in the brain, the AMPA-type glutamatereceptor. Dr. Greer’s research team demonstratedthat certain of these compounds stimulate aprimitive area of the brain called the pre-BotzingerComplex that controls breathing, without causing sideeffects. In animal models, the compounds were shownto enhance the respiratory drive and breathing rhythmin laboratory rats whose respiration rates were purposelysuppressed. AMPAKINES may one day serveas rescue therapies for patients exhibiting respiratorydepression, or perhaps an adjuvant to painkillers tomake them safer, as well as those who suffer fromsleep apnea.Mark Varney, Ph.D. is President and Chief ExecutiveOfficer of Cortex Pharmaceuticals, an Irvine, CA-basedneuroscience company focused on novel drug therapiesfor treating psychiatric disorders, neurological diseasesand sleep apnea.HEALTH CARE SUPPLY CHAIN MANAGEMENTA special focus of our highly regarded and long-standing supply chain programHome Health Care Services, Inc.Is Lighting The WayTo Better Patient Care• Home Health Care• Hospice Care• Palliative Care• In Home HealthUPMC supply chain management specialistBethany Gualiteri, a program graduate.Proudly Serves Patients andFamilies in the following counties:Allegheny, Beaver, Fayette,Washington, WestmorelandAlso, Parts of: Butler and Greene Rigorous curriculum Pittsburgh, Pa.Learn more about the region’s topHealth Care Supply Chain Managementprogram and its graduates, contact:Dr. John Mawhinney, CPIM, CTLDirector, Supply Chain Management Programswww.duq.edu/scmHomeCare Elite winner three years in arow in <strong>Western</strong> <strong>Pennsylvania</strong>1229 Silver Lane, Suite 201, Pittsburgh, PA 15136412.859.88011580 Broad Avenue Ext., Suite 1, Belle Vernon, PA 15012724.929.4712www.anovahomehealth.com
Issue No. <strong>10</strong> wphospitalnews.com| 17Helping Your Mind, Body, and Spirit Achieve a State of BalanceBy Kathleen GansterFor years, it often seemed that “traditional” medicinewas different and even at odds with “alternative”medicine.But more and more physicians are integrating themore non-traditional forms of healing into their practicesand teaming up with practitioners of alternative,natural health to care for their patients.Additionally, more health insurance companies areproviding benefits for these services such as massage.As the owner of medica...the healing arts and an “alternative”health care practitioner, Beverly Leopold hasoften tried to dispel myths that she can’t work hand-inhandwith a client’s physician to solve chronic healthissues.“I don’t like to refer to it as ‘alternative” health care,but rather complimentary healthcare,” said Leopold.For nearly 20 years, Leopold hasowned medica located in RichlandTownship and practiced natural,complimentary health care includingmassage, acupuncture, Reiki, reflexologyand other similar proceduresthat she refers to as “wellness techniques.”“Our sessions are clinical in natureand offer a complimentary factorto the healing process,” she said.Leopold, a certified massage therapist,certified hypnotherapist, andReiki master, knows that there arehealth problems that must be treatedby a physician.“I often refer someone to a physicianif they have symptoms of anoverlying health concern,” saidLeopold, “We work with our clientswithin the scope of our knowledge.”Leopold also works with physicianswho will refer patients to herthat have run the course through certainmedicines or procedures and arestill suffering with chronic pain thatmay be eased through massage orhypnosis.Leopold’s son, Rich Timmerman,is also a certified massage therapistand provides deep tissue massagethat works well with athletes recoveringfrom sports injuries andchronic health issues. medica alsohas a chiropractor on-site who incorporatesacupuncture into wellnesssessions.A key component in strengtheningthe partnership of complimentaryhealth-care providers andphysicians is the fact that in the stateof <strong>Pennsylvania</strong>, massage therapistsmust now be licensed. The law willrequire all massage therapists tohave completed the licensureprocess and be certified by December2012.A long-time proponent of licensing,Leopold thinks more physicianswill look at massage in a more seriousmanner with this new requirement.“This just takes us to a higherlevel. We work hard for our educationand training, and to have the licensingwill, I believe, make massage therapy ‘legitimate,’”said Leopold.Like traditional physicians, Leopold and Trimmermanwork with their client’s total health care issuesto ensure the optimal overall health.Along those lines, medica has recently teamed upwith Alexander’s fitness clubs and MyoFitness personaltrainers.“This follows the whole philosophy that goodhealth is total health with all of a client’s health careproviders working in harmony,” she said.Leopold will be hosting an open house for healthcare providers in early January. For more information,please contact Leopold at email: medica2beverly@msn.comor telephone at 724-449-2255. Visitwww.medicathehealingarts.com for more information.Only one local healthsystem has a simulationcenter that was recentlyrecognized as one ofthe best in the world.And it’s not whoyou think it is.Donald J. Wilfong Jr, MDMedical DirectorDonamarie N-Wilfong, DNP, RNDirector of Clinical EducationAt West Penn Allegheny’s Simulation, Teaching and AcademicResearch (STAR) Center, we provide state-of-the-art trainingfor healthcare professionals. Using the latest in tools andtechniques, the STAR Center hones the skills of today’shealthcare providers and prepares future clinicians for thefast-paced and challenging world of patient care. We valueevery patient, which is why students learn on highly advancedmannequins in our world-class simulation center beforethey enter a patient room. And, we’re the only center in theregion, and one of only <strong>10</strong> worldwide, accredited by theSociety for Simulation in <strong>Healthcare</strong>.When doctors lead, better care follows –call 412.DOCTORS (362.8677).Bev Leopold and her son, Rich Timmerman,owners of medicawpahs.org