Tocilizumab Treatment in COVID-19 Patients: Comparing Cutaneous Disease and Adverse Drug Effects.

Actemra (tocilizumab) received emergency use authorization for the treatment of coronavirus disease 2019 (COVID-19) in June 2021. Literature has linked numerous cutaneous adverse effects to tocilizumab. In this current survey, investigators reviewed and compared these adverse effects to the common cutaneous manifestations of COVID-19. While similarities in patient presentation exist, important distinctions are made to aid dermatologists in their clinical diagnosis.  J Drugs Dermatol. 2023;22(12):e42-e43.     doi:10.36849/JDD.6532e.

Nirmatrelvir-ritonivir, COVID-19, and possible adverse cutaneous reactions.

Nirmatrelvir-ritonivir (Paxlovid) recently received emergency use authorization for the treatment of coronavirus disease 2019 (COVID-19). Literature has linked numerous cutaneous adverse effects to nirmatrelvir and ritonavir, the copackaged tablets within Paxlovid. A review and comparison of these adverse effects to the common cutaneous manifestations of COVID-19 is provided. Numerous drug-to-drug interactions exist between nirmatrelvir-ritonivir and commonly-used medications within dermatology.

Parental leave in medical school: supporting students as parents.

CONTEXT: The overlap between medical school, residency, and childbearing potential increases the likelihood a woman will pursue parenthood within her, or her partner's, medical training. Parental leave benefits mothers, fathers, and infants. Adequate parental leave promotes physical recovery, mental health, infant bonding, improved breastfeeding, appropriate childhood immunization, and familial engagement. Despite the risks and benefits, the United States does not have national paid maternity, paternity, or parental leave requirements. Complicating matters for medical trainees, parental leave policies are not well-defined within the undergraduate (UME) and graduate medical education (GME) realms. Significant policy advancements are on the horizon for GME; however, medical schools are left without evidence to support policy formation. OBJECTIVES: This study aims to identify the presence and nature of maternal/paternal leave policies and procedures within UME. Given the authors' close association with osteopathic medical education, only osteopathic medical schools were considered to lay the framework for future study in UME. METHODS: Investigators searched university websites for student handbooks outlining rules and policies surrounding parental leave. The following terms were utilized to investigate these documents: "parental," "maternity," "paternity," "pregnant," "pregnancy," and "leave of absence" (LOA). Administrative personnel were contacted, and subjective data were documented. A parental leave policy was defined as explicitly dedicated to expectant parents or those parents planning on adoption. Medical leave or other short- and long-term LOA policies were not considered a parental leave policy. RESULTS: A total of 42 osteopathic medical schools were identified. Investigators established email communication with 17 schools (40.5%). Neither a student handbook nor email contact could be made with one institution. Two (4.9%) osteopathic medical schools overtly described parental leave in their policies. The majority of schools recommended students seeking parental leave follow short- or long-term LOA policies. CONCLUSIONS: Without protected leave time, students must decide whether to begin a family or delay medical education. As GME begins prioritizing policy change, the authors call on UME to follow suit. Parenthood and medicine must be intertwined.

Hydroxychloroquine Alternatives for Chronic Disease: Response to a Growing Shortage Amid the Global COVID-19 Pandemic.

With the emergence of a novel severe acute respiratory syndrome coronavirus, investigators worldwide are scrambling to identify appropriate treatment modalities, develop accurate testing, and produce a vaccine. To date, effective treatment remains elusive. Chloroquine phosphate and hydroxychloroquine sulfate (HCQ), well-known antimalarial drugs effective in the treatment of systemic lupus erythematosus, rheumatoid arthritis, porphyria cutanea tarda, and chronic Q fever, are currently under investigation. The United States Food and Drug Administration recently issued an Emergency Use Authorization for CQ and HCQ use in the treatment of coronavirus disease 2019 (COVID-19). With spikes in HCQ use and demand, ethical considerations encompassing appropriate use, patient autonomy, nonmaleficence, and distributive justice abound. As drug experts, pharmacists are uniquely positioned to advocate for patients with chronic conditions necessitating HCQ use, assist in the appropriate prescribing of HCQ for COVID-19, and ensure patients and health care professionals are continually educated during this public health crisis. This review highlights the worldwide pandemic, describes appropriate HCQ use for chronic conditions, highlights available alternatives, and deliberates evolving ethical questions. With assistance from colleagues, state boards of pharmacy, and national organizations, pharmacists ensure the just distribution of valuable pharmaceuticals to patients having COVID-19 while supporting the needs of patients requiring HCQ for chronic conditions.