Yellowjackets -- the wasp/hornet

When I first heard of this many years ago, in a story about a study of potency and safety of decades-old drugs stored in government warehouses, IIRC it indicated that the toxic breakdown products were from an old form of tetracycline, no longer produced. Newer formulations still broke down with age, but were no longer toxic. Aspirin also broke down comparatively rapidly with age, but to non-toxic vinegar. The great majority of other old drugs in that study were still good.

I'm not finding that item very old item again, but do find a few similar items:

NPR (2017): That Drug Expiration Date May Be More Myth Than Fact

"... In 1986, the Air Force, hoping to save on replacement costs, asked the FDA if certain drugs' expiration dates could be extended. In response, the FDA and Defense Department created the Shelf Life Extension Program.

Each year, drugs from the stockpiles are selected based on their value and pending expiration, and analyzed in batches to determine whether their end dates could be safely extended. For several decades, the program has found that the actual shelf life of many drugs is well beyond the original expiration dates.

A 2006 study of 122 drugs tested by the program showed that two-thirds of the expired medications were stable every time a lot was tested. Each of them had their expiration dates extended, on average, by more than four years, according to research published in the Journal of Pharmaceutical Sciences.

Some that failed to hold their potency include the common asthma inhalant albuterol, the topical rash spray diphenhydramine, and a local anesthetic made from lidocaine and epinephrine, the study said. But neither Cantrell nor Dr. Cathleen Clancy, associate medical director of National Capital Poison Center, a nonprofit organization affiliated with the George Washington University Medical Center, had heard of anyone being harmed by any expired drugs. Cantrell says there has been no recorded instance of such harm in medical literature."

The linked 2006 study of 122 drugs: DocumentCloud


Other links:


Nursing2024

"A handful of case reports from decades ago linked oral antibiotic tetracycline to a reversible form of kidney damage called Fanconi sydrome when taken after the expiration date. ... However no similar cases involving tetracycline or related antibiotics ... have been reported in recent years."

drugs - What happens to the structure of tetracyclines when they expire? - Chemistry Stack Exchange
"It is worth noting that renal tubular acidosis (RTA) - the condition that was reported in 1963 to have been precipitated by ingestion of expired tetracycline - is not presently considered as much of an issue as it was at the time (see this review). Finally, this piece in the New York Times from 2014 (entitled Do some drugs become dangerous after expiration?) has more information and references concerning tetracycline and RTA."

 

The above NPR story has a section specifically about EpiPens:

"... Cantrell and Gerona published a study that examined 40 EpiPens and EpiPen Jrs., a smaller version, that had been expired for between one and 50 months. The devices had been donated by consumers, which meant they could have been stored in conditions that would cause them to break down, like a car's glove box or a steamy bathroom. The EpiPens also contain liquid medicine, which tends to be less stable than solid medications.

Testing showed 24 of the 40 expired devices contained at least 90 percent of their stated amount of epinephrine, enough to be considered as potent as when they were made. All of them contained at least 80 percent of their labeled concentration of medication. The takeaway? Even EpiPens stored in less than ideal conditions may last longer than their labels say they do, and if there's no other option, an expired EpiPen may be better than nothing, Cantrell says."

I'm remembering a long ago story of a mother finding her daughter going into anaphylactic shock, and finding the available EpiPen expired, so out of fear it might have gone bad, didn't use it. The daughter died. The story, and advice from a mountain first aid class around the same era, said 'use it anyway. The expired EpiPen is not known to be a risk to life, and may still be beneficial, even if not full strength anymore. The anaphylactic shock is a risk to life.'

 

nee

Circling back on this.
It would appear that if one lives on free soil, Hypodermic needles may be purchased and delivered freely.
OK....maybe not freely.
Jeff has rockets and horribly run newspapers to fund.


It would appear that (as with many things) "freedom" is a politically charged term and some people will rapidly and shamelessly switch polarity accordingly.


Epinephrine OTOH, is somewhat different, AND somewhat the same!


One can buy all of it that they want to but then we enter the rocks and shoals where Money, $cience, and Politics all intersect!!!
Ivermectin: a multifaceted drug of Nobel prize-honoured distinction with indicated efficacy against a new global scourge, COVID-19 - PubMed

Speaking of rocks and shoals, this is where Chevron may start to UNTANGLE things......

 

The link for my comment was referencing a study from 2000 that found reduced bioavailability of the epinephrine after 1 to 90 months past the date. It also left out the part about using the expired epi-pen anyway that was in its reference.

 

chlordane was our weapon of choice for all sorts of stinging bugs (especially brown recluse infestations) in the 70's & 80's. Even wiped out subterranean termites with one application & lasted for years. But the environmental & people harm outweighed the good. Suffered some of the harm, personally.
.

 

Used it myself until they took it off the market - for a good reason.

 

of all the biting/stinging insects that bother us in the daytime, yellow jackets seem the most aggressive.
you can't be sure if they are going to sting you as they constantly buzz your head and hide behind you so you can't tell if they've landed.
i have no idea what it is they are looking for

 

lookin' for love in all the wrong places

 

As a kid of the 60s mom & dad would take us vacationing up to the Rogue River oregon. Soon as we started grilling - the Yellow Jackets (or hornets) would come out in force. The locals there called them meat bees.
.

 

What prices does this site give for your location, for generics? More my area, it shows a couple nearby at $111.25, and three more under $150:

Epipen Prices, Coupons & Savings Tips - GoodRx

See also:

EpiPen Costs and Alternatives: What Are Your Best Options?

 

It's like charging $50 for Narcan - down from several times that ONLY because of the immense demand.
I understand that Rx companies must recover their non-recurring expenses but ......this challenges my libertarian underpinnings.

 

(sigh) stepfather-in-law passed just a few months ago because he had no EpiPen, because the cost was prohibitive in socal.
.

 

Have you been looking at generics and alternatives? "EpiPen®" is a registered trademark of one particular company, Mylan. But this isn't something where brand loyalty is needed.

Here is what GoodRX currently shows for its coupons in the Seattle area, for generics:



Searches keep coming up with a $10 deal ($110 price with $100 manufacturer discount coupon), but it looks seriously outdated. I seem to remember news in past years mentioning other alternatives.

Keep watch on another potential alternative, an epinephrine nasal spray, not yet FDA approved as it keeps asking for 'one more study':

9/19/2023: FDA rejects first needle-free alternative to EpiPens, calling for more research
The move came as a surprise: In May, an FDA advisory committee voted to recommend approval of the drug for children and adults.

6/28/2024: EU regulator backs approval for ARS Pharma's nasal spray alternative to EpiPen

3/1/2024: Epinephrine Nasal Spray Starts Reversing Allergic Reactions in Minutes

10/10/2023: An EpiPen Alternative Could Make Treating Anaphylaxis Easier—Especially in Schools

 

Nasal Spray Starts Reversing Allergic Reactions in Minutes...

I do not know.
The line forms on ME to doubt the motives or even the effectiveness of $cience when it comes to medicine and Pharma's influence but shouldn't this stuff work faster than "minutes?"
It's like the old joke about Police response time during a home invasion....
"when seconds count, we'll be there in minutes."

Eppy pens are a little more complicated than insulin.
It's not just the $150 for the one pen and 'you're covered.'
One pen - might extend the runway enough to get you to a hospital and prevent your next of kin from picking out your coffin but more severe sufferers might need two - and unless you duct tape them to your leg they're probably going to be somewhere else when you really REALLY need one, especially if you do yard work - or work work, to have more than one purse - or car.
I don't have one (or two) because I have been stung before and have only suffered moderate symptoms - so if I disturb a bunch of wasps while I'm 20 minutes from town then it's not state-assisted homicide, but rather ME making a perhaps ill informed choice.

I OWN that responsibility.

However (comma!!!) I also understand that hospitals didn't use 'epipens' pack in the day.
THEY often as not had a $0.10 1cc syringe pre-loaded with $0.10 worth of Eppy in a bag taped to the wall where they gave injections.

 

Spray just at the early morning twilight as it's cool and it's less likely any will be able to fly much less come and get you