Friday, March 16, 2012
My Apologies For Not Having A Blog Out Lately
I am sorry for not having a blog out recently but my next blog has taken a lot of research and should be out shortly.
Tuesday, February 28, 2012
The Dangers of Giving Your Pet Over The Counter Medication Without Veterinary Advice
Were you aware that many over the counter (OTC) medications and herbal or homeopathic remedies can cause the death of your pet? It is not unusual for people to go to a pharmacist for advice when it comes to treating their pets for common ailments (e.g. stomach upset to diarrhea, fevers, minor aches or pains, and even motion sickness). Although, pharmacists are very knowledgeable with these medications for use in humans, many of them know very little about their potential dangers when given to animals. Always ask if the pharmacist is knowledgeable in this field or has reference materials to rely on for this information. If not, always consult with your veterinarian's office prior to giving your pet any OTC medication or homeopathic or herbal remedies.
The American Veterinary Medical Association (AVMA) says that drug poisoning is the most common cause of small animal poison exposure. The potential dangers arise from the fact that different animals breakdown or metabolize medications and homeopathic or herbal remedies differently. What is perfectly safe for you to take could lead to potential toxicity, illness or even death to your pet. Note that there are medications specifically made for animal use that may also have a human formulation. Some of these human formulations cannot be used in animals without causing harm. Perfect examples of this would be a diphenhydramine liquid or chewable tablet or a toothpaste that contains xylitol. Xylitol is a sugar substitute that is used as a sweetener. It is not only found in OTC medications and toothpastes, xylitol can be found in sugar-free chewing gums, candies, breath mints and sprays. The ingestion of xylitol by dogs can trigger significant insulin release from the pancreas causing a sharp drop in blood sugar levels, resulting in loss of coordination, seizures, depression, liver damage, and even death with repeated use.
One of the most common questions is "Can I give my dog or cat Tylenol (acetaminophen)?" Lets concentrate on dogs first. You need to discuss this with your veterinarian. If it is acceptable then it should be for short term use and at the appropriate dosage. This determination should be made by your veterinarian since it is calculated by the weight and breed of the dog. Otherwise, you risk destroying red blood cells resulting in anemia. You also put your dog at risk of developing irreversible liver damage which left untreated could result in death. The other thing to remember is that when administering acetaminophen to your dog using a liquid or chewable dosage form, make sure it does not contain the artificial sweetener xylitol that is mentioned above. Now for cats, NEVER EVER give acetaminophen to a cat. A cat's liver is not capable of breaking down acetaminophen and even the smallest amount leads to liver failure and death. If your cat has ingested acetaminophen accidentally, seek the help of a veterinarian immediately.
Aspirin is also another drug with which to be cautious when medicating pets. Aspirin should not be used by cats because it can not be completely metabolized by the liver for a period of 3-4 days which can lead to toxic levels and death. This, however, does not mean it can't be given but it should only be under the direct supervision of a veterinarian. Be aware that Pepto-Bismol and Kaopectate both contain byproducts of aspirin. Aspirin causes stomach bleeding in dogs so, only buffered aspirin should be used, prescibed by a veterinarian.
The same holds true for other non-steroidal anti-inflammatory drug (NSAIDs) like Advil (ibuprofen) and Aleve (narproxen). A cat's liver cannot break down these drugs and toxic levels accumulate. This is true of dogs too with some NSAIDs , although the sensitivity of their stomachs and intestinal tracts is the main concern. Their use can cause bleeding, ulcers, and perforations in the stomach or intestines. Either way, their use in cats and dogs should be used under the supervision of a veterinarian because NSAID toxicity can lead to shock, seizures, renal failure, and ultimately death. There are only a few NSAIDs available for pets which are specifically manufactured for them and should only used if prescribed by your veterinarian.
Local or topical anesthetics like Benzocaine Spray or other OTC products that contain lidocaine or benzocaine can be harmful to pets if not applied properly or ingested. They can affect the pets central nervous system (CNS) causing seizures and they can affect muscle control even that of the heart which could lead to irregular heart beats and possibly death.
As far as herbal or homeopathic remedies found in your local drug store, health food store, or supermarket that are made for human use, most are not recommended for pet use. There are, however, some products that are safe as long as used at the correct dosages and forms (e.g. tablets, capsules, liquids, or chewables ) . Examples of these are glucosamine & chondroiton for arthritic conditions, milk thistle for liver protection and health, valerian root for insomnia or anxiety, cranberry extracts for prevention against recurring urinary tract infections, and ginger root for nausea or motion sickness. It is extremely important to verify the dosages to be administered with your veterinarian before use.
There are OTC medications that are safe for your pets and can be used as long as you verify the dosage to be used. Dramamine can be used for cats and dogs for motion sickness. It should be given 40 to 60 minutes prior to travel and will last up to 6 hours. Antihistamines; Chlortrimeton (chlorpheniramine), Benadryl (diphenhydramine) are commonly used for sedation, itching or allergies. Imodium (loperamide) is another over the counter medication that is safe to use for cats and dogs for diarrhea. Just be careful of using the liquid form because it may contain alcohol which can be toxic to cats and dogs.
Although I am knowledgeable when it comes to medications for pet use, I recommend that you consult with your veterinarian before administering any medications to your pet. One of the main reasons is that your pet may have a preexisting medical condition that would prohibit its use. The other reason is that animals metabolize medications differently which is not only limited to the type of animal, but even the breed. Remember if buying an OTC medication for your pet make sure you are buying exactly what was recommended and not a combination product that may contain something that is poisonous or toxic to your pet such as acetaminophen, Sudafed (pseudoephedrine), xylitol, or alcohol.
Lastly, in the case of accidentally overdosing your pet or in the case of a pet poisoning, you should have the number to a 24 hour veterinary hospital or the phone number for Animal Poison Control Center Hotline (888-426-4435) available and within reach.
The American Veterinary Medical Association (AVMA) says that drug poisoning is the most common cause of small animal poison exposure. The potential dangers arise from the fact that different animals breakdown or metabolize medications and homeopathic or herbal remedies differently. What is perfectly safe for you to take could lead to potential toxicity, illness or even death to your pet. Note that there are medications specifically made for animal use that may also have a human formulation. Some of these human formulations cannot be used in animals without causing harm. Perfect examples of this would be a diphenhydramine liquid or chewable tablet or a toothpaste that contains xylitol. Xylitol is a sugar substitute that is used as a sweetener. It is not only found in OTC medications and toothpastes, xylitol can be found in sugar-free chewing gums, candies, breath mints and sprays. The ingestion of xylitol by dogs can trigger significant insulin release from the pancreas causing a sharp drop in blood sugar levels, resulting in loss of coordination, seizures, depression, liver damage, and even death with repeated use.
One of the most common questions is "Can I give my dog or cat Tylenol (acetaminophen)?" Lets concentrate on dogs first. You need to discuss this with your veterinarian. If it is acceptable then it should be for short term use and at the appropriate dosage. This determination should be made by your veterinarian since it is calculated by the weight and breed of the dog. Otherwise, you risk destroying red blood cells resulting in anemia. You also put your dog at risk of developing irreversible liver damage which left untreated could result in death. The other thing to remember is that when administering acetaminophen to your dog using a liquid or chewable dosage form, make sure it does not contain the artificial sweetener xylitol that is mentioned above. Now for cats, NEVER EVER give acetaminophen to a cat. A cat's liver is not capable of breaking down acetaminophen and even the smallest amount leads to liver failure and death. If your cat has ingested acetaminophen accidentally, seek the help of a veterinarian immediately.
Aspirin is also another drug with which to be cautious when medicating pets. Aspirin should not be used by cats because it can not be completely metabolized by the liver for a period of 3-4 days which can lead to toxic levels and death. This, however, does not mean it can't be given but it should only be under the direct supervision of a veterinarian. Be aware that Pepto-Bismol and Kaopectate both contain byproducts of aspirin. Aspirin causes stomach bleeding in dogs so, only buffered aspirin should be used, prescibed by a veterinarian.
The same holds true for other non-steroidal anti-inflammatory drug (NSAIDs) like Advil (ibuprofen) and Aleve (narproxen). A cat's liver cannot break down these drugs and toxic levels accumulate. This is true of dogs too with some NSAIDs , although the sensitivity of their stomachs and intestinal tracts is the main concern. Their use can cause bleeding, ulcers, and perforations in the stomach or intestines. Either way, their use in cats and dogs should be used under the supervision of a veterinarian because NSAID toxicity can lead to shock, seizures, renal failure, and ultimately death. There are only a few NSAIDs available for pets which are specifically manufactured for them and should only used if prescribed by your veterinarian.
Local or topical anesthetics like Benzocaine Spray or other OTC products that contain lidocaine or benzocaine can be harmful to pets if not applied properly or ingested. They can affect the pets central nervous system (CNS) causing seizures and they can affect muscle control even that of the heart which could lead to irregular heart beats and possibly death.
As far as herbal or homeopathic remedies found in your local drug store, health food store, or supermarket that are made for human use, most are not recommended for pet use. There are, however, some products that are safe as long as used at the correct dosages and forms (e.g. tablets, capsules, liquids, or chewables ) . Examples of these are glucosamine & chondroiton for arthritic conditions, milk thistle for liver protection and health, valerian root for insomnia or anxiety, cranberry extracts for prevention against recurring urinary tract infections, and ginger root for nausea or motion sickness. It is extremely important to verify the dosages to be administered with your veterinarian before use.
There are OTC medications that are safe for your pets and can be used as long as you verify the dosage to be used. Dramamine can be used for cats and dogs for motion sickness. It should be given 40 to 60 minutes prior to travel and will last up to 6 hours. Antihistamines; Chlortrimeton (chlorpheniramine), Benadryl (diphenhydramine) are commonly used for sedation, itching or allergies. Imodium (loperamide) is another over the counter medication that is safe to use for cats and dogs for diarrhea. Just be careful of using the liquid form because it may contain alcohol which can be toxic to cats and dogs.
Although I am knowledgeable when it comes to medications for pet use, I recommend that you consult with your veterinarian before administering any medications to your pet. One of the main reasons is that your pet may have a preexisting medical condition that would prohibit its use. The other reason is that animals metabolize medications differently which is not only limited to the type of animal, but even the breed. Remember if buying an OTC medication for your pet make sure you are buying exactly what was recommended and not a combination product that may contain something that is poisonous or toxic to your pet such as acetaminophen, Sudafed (pseudoephedrine), xylitol, or alcohol.
Lastly, in the case of accidentally overdosing your pet or in the case of a pet poisoning, you should have the number to a 24 hour veterinary hospital or the phone number for Animal Poison Control Center Hotline (888-426-4435) available and within reach.
Sunday, February 12, 2012
Understanding The Common Cold And Over The Counter Options For Treatment
The majority of the population has experienced the frustration of contracting the common cold. That pounding headache or unbearable sinus headache that comes from congestion. That unpleasant scratchy or sore throat usually caused by a post nasal drip where the mucous secretions are draining from the sinuses and nasal passages, down the back of the throat. That annoying or hacking cough caused by the post nasal drip. The occasional earache or ear discomfort that develops in more severe cases where a lot of sinus pressure is seen.
There are over one hundred different rhinoviruses (viruses that affect the upper respiratory tract; eyes, nose, sinuses, ears, and throat) that people catch over a billion times a year worldwide causing them to come down with the common cold. These viruses usually enter the body through the eyes or the nose. The viruses, then, attack the membranes in the nasal and sinus passages. The viruses replicate so quickly that the above symptoms start to appear anywhere from 10 to 12 hours after contact with the virus.
Antibiotics are of no value, unfortunately, since the common cold is caused by a virus not a bacteria. Taking them can make conditions worse by killing harmless bacteria normally found in the upper respiratory tract. The virus, then infiltrates these areas giving and replicate.
In the past, people with the common cold were treated with the use of analgesics, decongestants, antihistamines, mucolytics, and cough suppressants. Natural and homeopathic remedies have also been used. They include such things as vitamin C, zinc tablets, echinacea, golden seal root, and eyebright. However, due to the poor and unreliable data collected from research studies completed, there is no hard evidence that these homeopathic remedies are of any great benefit.
The common cold lasts around 8 days, maybe a little bit longer. People who use the zinc lozenges reduce this by almost 4 days, cutting the duration by almost half. The only side effects reported when using zinc lozenges are alterations in taste perception, nausea and a very small number of unsubstantiated claims of loss of smell which can not be backed up by any clinical data to date. The nausea is not severe and usually can be reduced by sucking the lozenges after eating a snack or small meal. These side effects are also reversible after discontinuing the lozenges. As far as the loss of sense of smell the jury is still out on this side effect since many rhinoviruses can also cause loss of smell. Zinc lozenges have very few drug interactions. This makes them good for people who are taking a lot of different medications. All of the data is not in yet on their use with pregnant women and women who are breast feeding. These women should check with their doctor or pediatrician before use. These lozenges also should not be used by people who are immunocompromised such as transplant patients or other patients who are taking immunosuppressant medication.
Since no one can avoid the common cold, my first recommendation is to take zinc gluconate glycine lozenges as soon as you recognize any of the symptoms of a cold coming on. It is very important that you take the lozenges, not a tablet or capsule formulation. The exact way they work is still not 100% understood and I will try to explain it as simply as possible. By sucking on the lozenges the zinc formulation binds to a substance in your tissues through direct contact and stops or competes with the rhinovirus preventing it from replicating. This reduces the symptoms and duration of the cold. My second recommendation is to treat the cold symptomatically with analgesics (for the aches and pains), nasal decongestants (to relieve any congestion or sinus pressure), antihistamines and mucolytics (for any problems with mucous and post nasal drip), and lastly a cough suppressant if required. Also, stay away from dairy products which are mucous forming and drink plenty of clear fluids (6-8) glasses a day if you have no prior medical condition that prohibits this.
Listed below are the over the counter products for treating the common cold besides zinc gluconate glycine lozenges which are available in both a regular and sugar free formulation.
ANALGESICS (PAIN RELIEVER)
* I do not recommend the nasal sprays for any longer than 3 days. Use longer than this can cause a condition known as rebound congestion. This happens when the nasal spray drys the nasal and sinus passages out so much it actually burns the tissue causing it to produce more mucous as a healing process making the congestion worse than it was when the cold started. The body can also develop a physical dependence upon these nasal spray just to alleviate this never ending cycle of congestion.
If you have any questions regarding any of the products used or combination products used to treat the common cold please feel free to e-mail me at ejjoycerph@gmail .com and I will respond as quickly as possible. I also look forward to any comments either positive or negative so I can continue to improve the blog. I also welcome any topics relating to my blog that you would like to know more about.
There are over one hundred different rhinoviruses (viruses that affect the upper respiratory tract; eyes, nose, sinuses, ears, and throat) that people catch over a billion times a year worldwide causing them to come down with the common cold. These viruses usually enter the body through the eyes or the nose. The viruses, then, attack the membranes in the nasal and sinus passages. The viruses replicate so quickly that the above symptoms start to appear anywhere from 10 to 12 hours after contact with the virus.
Antibiotics are of no value, unfortunately, since the common cold is caused by a virus not a bacteria. Taking them can make conditions worse by killing harmless bacteria normally found in the upper respiratory tract. The virus, then infiltrates these areas giving and replicate.
In the past, people with the common cold were treated with the use of analgesics, decongestants, antihistamines, mucolytics, and cough suppressants. Natural and homeopathic remedies have also been used. They include such things as vitamin C, zinc tablets, echinacea, golden seal root, and eyebright. However, due to the poor and unreliable data collected from research studies completed, there is no hard evidence that these homeopathic remedies are of any great benefit.
In recent years, research has shown reliable evidence on the use of zinc gluconate glycine lozenges for use in the common cold. One study analyzed the duration of the common cold, as well as any lessening of symptoms during this time period. It proved astonishing results if the lozenges were started in the first 24 hours of noticing any onset of cold symptoms. Half of the study participants were given 13.3mg of zinc gluconate glycine lozenges while the other half were given just plain placebo (inactive) lozenges. The participants were given lozenges every 2 hours while awake. In both cases, the zinc lozenges reduced the severity of the symptoms and duration of the colds. The treatment should continue until symptoms subside, but never longer than a week. Short time use of the zinc is of great benefit, however, using zinc for too long can be toxic to your body. Too much zinc can weaken your immune system, decrease the amount good cholesterol in your body as well as deplete your body of other important minerals such as copper.
The common cold lasts around 8 days, maybe a little bit longer. People who use the zinc lozenges reduce this by almost 4 days, cutting the duration by almost half. The only side effects reported when using zinc lozenges are alterations in taste perception, nausea and a very small number of unsubstantiated claims of loss of smell which can not be backed up by any clinical data to date. The nausea is not severe and usually can be reduced by sucking the lozenges after eating a snack or small meal. These side effects are also reversible after discontinuing the lozenges. As far as the loss of sense of smell the jury is still out on this side effect since many rhinoviruses can also cause loss of smell. Zinc lozenges have very few drug interactions. This makes them good for people who are taking a lot of different medications. All of the data is not in yet on their use with pregnant women and women who are breast feeding. These women should check with their doctor or pediatrician before use. These lozenges also should not be used by people who are immunocompromised such as transplant patients or other patients who are taking immunosuppressant medication.
Since no one can avoid the common cold, my first recommendation is to take zinc gluconate glycine lozenges as soon as you recognize any of the symptoms of a cold coming on. It is very important that you take the lozenges, not a tablet or capsule formulation. The exact way they work is still not 100% understood and I will try to explain it as simply as possible. By sucking on the lozenges the zinc formulation binds to a substance in your tissues through direct contact and stops or competes with the rhinovirus preventing it from replicating. This reduces the symptoms and duration of the cold. My second recommendation is to treat the cold symptomatically with analgesics (for the aches and pains), nasal decongestants (to relieve any congestion or sinus pressure), antihistamines and mucolytics (for any problems with mucous and post nasal drip), and lastly a cough suppressant if required. Also, stay away from dairy products which are mucous forming and drink plenty of clear fluids (6-8) glasses a day if you have no prior medical condition that prohibits this.
Listed below are the over the counter products for treating the common cold besides zinc gluconate glycine lozenges which are available in both a regular and sugar free formulation.
ANALGESICS (PAIN RELIEVER)
- Aspirin (but not recommended for ages under 13)
- Acetaminophen
- Ibuprofen
- Pseudoephedrine
- Phenylephrine
- *Oxymetazoline (nasal spray)
- Diphenhdramine
- Chlorpheniramine
- Loratadine (non-sedating)
- Cetirizine (non-sedating)
- Dextromethorphan
- Guaifenesin
* I do not recommend the nasal sprays for any longer than 3 days. Use longer than this can cause a condition known as rebound congestion. This happens when the nasal spray drys the nasal and sinus passages out so much it actually burns the tissue causing it to produce more mucous as a healing process making the congestion worse than it was when the cold started. The body can also develop a physical dependence upon these nasal spray just to alleviate this never ending cycle of congestion.
If you have any questions regarding any of the products used or combination products used to treat the common cold please feel free to e-mail me at ejjoycerph@gmail .com and I will respond as quickly as possible. I also look forward to any comments either positive or negative so I can continue to improve the blog. I also welcome any topics relating to my blog that you would like to know more about.
Thursday, February 9, 2012
A New Form Of CPR Without Mouth To Mouth Contact That Could Save The Life Of A Loved One Or Even Your Own If You Share This Information
If it wasn't for a recent cardiac episode that I encountered I probably would not even be posting this on my blog right now. Life is too precious a gift and can be taken from us or our loved ones in a blink of an eye. So I urge you to please click on the link below after reading the rest of this. Remember every second counts waiting for the paramedics or the police to arrive may be too late. This is how I lost my father, because the loved ones surrounding him at the time did not know what to do. I only wish to God that this information was available to my family members who were with him at the time. My mother may have still had a husband, His four children may have still of had a father and he would have gotten to know all of his grandchildren not just my first four.
"Every three days, more Americans die from sudden cardiac arrest than the number who died in the 9-11 attacks. You can lessen this recurring loss by learning Continuous Chest Compression CPR, a hands-only CPR method that doubles a person’s chance of surviving cardiac arrest. It’s easy and does not require mouth-to-mouth contact...... Please watch this video. It's a matter of life or death!" (quoted from the link below)
http://medicine.arizona.edu/
"Every three days, more Americans die from sudden cardiac arrest than the number who died in the 9-11 attacks. You can lessen this recurring loss by learning Continuous Chest Compression CPR, a hands-only CPR method that doubles a person’s chance of surviving cardiac arrest. It’s easy and does not require mouth-to-mouth contact...... Please watch this video. It's a matter of life or death!" (quoted from the link below)
http://medicine.arizona.edu/
Tuesday, February 7, 2012
ON THE LIGHTER SIDE; A FEW PHARMACY JOKES
Prescription Cyanide
A nice, calm and respectable lady went into a pharmacy, walked up to the Pharmacist, looked straight into his eyes, and said, "I would like to buy some Cyanide."
The pharmacist asked, "Why in the world do you need cyanide?" The lady replied, "I need it to poison my husband."
The pharmacist's eyes got big and he exclaimed, "Lord have mercy! I can't give you cyanide to kill your husband. That's against the law! I'll lose my license! They'll throw both of us in jail! All kinds of bad things will happen. Absolutely not! You CANNOT have any cyanide!"
The lady reached into her purse and pulled out a picture of her husband in bed with the pharmacist's wife.
The pharmacist looked at the picture and replied, "Well now, that's different. You didn't tell me you had a prescription."
Source MediJokes.Com :)
Blonde @ the Pharmacy
A blonde walks into a pharmacy and asks the assistant for some rectum deodorant.
The pharmacist, a little bemused, explains to the woman that they don't sell rectum deodorant and never have.
Unfazed, the blonde assures the pharmacist that she has been buying the stuff from this store on a regular basis and would like some more.
"I'm sorry," says the pharmacist, "We don't have any."
'But, I always buy it here,' says the blonde .
"Do you have the container that it came in?" asks the pharmacist.
"Yes," said the blonde, "I'll go home and get it."
She returns with the container and hands it to the pharmacist who looks at it and says to her, "This is just a normal stick of underarm deodorant."
Annoyed, the blonde snatches the container back and reads out loud from the container ...
"IT SAYS QUITE CLEARLY HERE ... TO APPLY, PUSH UP BOTTOM."
Source MediJokes.Com :)
I was asked to give a keynote address at a medical conference being that I am the head physician at a local hospital. I wrote up the speech on a small piece of paper very sloppily, but when I took it out to begin speaking I couldn’t seem to read it. I realized very quickly that it’s going to become a very embarrassing situation, so I looked up and started my speech, “good evening, are there any pharmacist’s in the house?”
Source funniestcleanjokes.com
Sorting Though The Omega Fatty Acids For The Heart And Cholesterol
Omega fatty acids include docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and alpha-linoleic acid (ALA). The DHA and the EPA can be found fish, whereas, ALA is found in soy, flaxseed, English walnuts, and canola oil. These omega fatty acids can be divided in two ways. First by source; fish or plant and second by type omega-3's, omega-6's, and omega-9's.
Omega-3 fatty acids from fatty fish such as salmon and albacore contain the highest amounts of DHA and EPA. According to the American Heart Association they have the best evidence for heart benefits and in lowering triglycerides a component of cholesterol. It should be noted that omega-3 fatty acid DHA/EPA from a fatty fish source can not be tolerated it is also extracted from krill a shrimp like shellfish, however, I do not recommend it since there is no data supporting its benefit.
Omega-3 fatty acids from plant sources contain ALA and do not contain DHA/EPA. Plant omega-3's are different than fish omega-3's. In fact, plant omega-3's have no hard evidence in benefiting the heart or lowering triglycerides. The ALA contained in these products derived from flaxseed and canola oil do have evidence in the reduction of LDL cholesterol.
As far omega-6's and omega-9's these fatty acids are considered to be healthy for the heart. However, these two fatty acids should never be recommended as supplements. Omega-6 fatty acid is linoleic acid and most people get enough of this from our everyday diet. Omega-9 fatty acid is oleic acid it is found in poly unsaturated oils like olive oil and can have an effect in lowering lipids, however, when needed our body can produce this fatty acid naturally.
I usually get three main questions about omega-3 supplements. One, are they safe to take even during pregnancy and do I have to worry about the heavy metal poisoning from the mercury in the fish the omega-3 fatty acid is derived from. Two, are they safe to take with my other medications and three, which brand do you recommend.
First as to this question the easiest thing for me to refer to you to a website that can give you up to date information on the mercury levels found in the fish used for omega-3 fatty acids the website is http://www.epa.gov/waterscience/fishadvice/advice.html.
Second are they safe to take with other medications I am presently on? Make sure that you ask your pharmacist and he will have you discuss its use with your physician if necessary, especially you are planning to take it because doses in excess of 2 grams a day could interact with aspirin, Coumadin (warfarin), or Plavix. It is also a good idea to let your doctor add it to your patient profile in case he decides to prescribe any of these medications in the future.
Third what brand do I recommend, The patient really has two choices now, especially since it is available by prescription under the name of Lovaza and available other the counter. If you purchase the over the counter version it is available under many different labels by a wide variety of manufactures, so make sure that label contains the letter USP somewhere after the name. This way you are guaranteed to get the strength that is actually labeled on the bottle.
Omega-3 fatty acids from fatty fish such as salmon and albacore contain the highest amounts of DHA and EPA. According to the American Heart Association they have the best evidence for heart benefits and in lowering triglycerides a component of cholesterol. It should be noted that omega-3 fatty acid DHA/EPA from a fatty fish source can not be tolerated it is also extracted from krill a shrimp like shellfish, however, I do not recommend it since there is no data supporting its benefit.
Omega-3 fatty acids from plant sources contain ALA and do not contain DHA/EPA. Plant omega-3's are different than fish omega-3's. In fact, plant omega-3's have no hard evidence in benefiting the heart or lowering triglycerides. The ALA contained in these products derived from flaxseed and canola oil do have evidence in the reduction of LDL cholesterol.
As far omega-6's and omega-9's these fatty acids are considered to be healthy for the heart. However, these two fatty acids should never be recommended as supplements. Omega-6 fatty acid is linoleic acid and most people get enough of this from our everyday diet. Omega-9 fatty acid is oleic acid it is found in poly unsaturated oils like olive oil and can have an effect in lowering lipids, however, when needed our body can produce this fatty acid naturally.
I usually get three main questions about omega-3 supplements. One, are they safe to take even during pregnancy and do I have to worry about the heavy metal poisoning from the mercury in the fish the omega-3 fatty acid is derived from. Two, are they safe to take with my other medications and three, which brand do you recommend.
First as to this question the easiest thing for me to refer to you to a website that can give you up to date information on the mercury levels found in the fish used for omega-3 fatty acids the website is http://www.epa.gov/waterscience/fishadvice/advice.html.
Second are they safe to take with other medications I am presently on? Make sure that you ask your pharmacist and he will have you discuss its use with your physician if necessary, especially you are planning to take it because doses in excess of 2 grams a day could interact with aspirin, Coumadin (warfarin), or Plavix. It is also a good idea to let your doctor add it to your patient profile in case he decides to prescribe any of these medications in the future.
Third what brand do I recommend, The patient really has two choices now, especially since it is available by prescription under the name of Lovaza and available other the counter. If you purchase the over the counter version it is available under many different labels by a wide variety of manufactures, so make sure that label contains the letter USP somewhere after the name. This way you are guaranteed to get the strength that is actually labeled on the bottle.
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Monday, February 6, 2012
More E-Mail Questions I Could Not Ignore
Another question that I have gotten hundreds of time over my career is about mosquito bites and I just couldn't ignore this e-mail.
Question; " I suffer terribly every time I am bitten by a mosquito. I end up with welts the size of half dollars and all I want to do is scratch them until they bleed. Due you have any answers that could help?"
Answer; After a mosquito sucks your blood, the mosquito will leave its saliva in your body along with any bacterial or virus it may be carrying from a previous victim. This saliva will cause a histamine reaction. Depending on your bodies sensitivity you can develop anything from a small red bump to a huge welt. If you think that you have a good chance of being bitten by a mosquito I recommend using mosquito repellent as well as taking a long acting antihistamine each day such as Zyrtec or the generic cetirizine once a day and at the same time each day. If you are already using a mosquito repellent and taking the cetirizine and you notice you are bitten I recommend a remedy my grandmother who was also a pharmacist passed down to me. Take some Adolf's Meat tenderizer (or any generic form will suffice) pour a little bit onto a spoon, add a few drops of water and mix together until you have formed a thick paste (note it will be a little bit gritty) then apply the paste directly to the bite area. This will help remove the itching within minutes. If need be, cover the area with a bandage for no more than 2 hours just long enough to keep the paste on that area and be absorbed at the site of the bite. If the area is really itchy I suggest you rub an ice cube over the bite for 2-3 minutes prior to applying this mixture.
Question; "I have bad knees and take ibuprofen daily for the pain. I have had friends tell me about a compound called glucosamine does it really work."
Answer; The product you are looking for is a combination product called glucosamine-chondroiton. It should be noted that it is not a quick fix it can take up to three months before you begin to notice any changes in your joint linings or joint pain. For adults I recommend you buy a product that comes in a 5:4 ratio. You want to find a capsule formulation not a tablet which contains 500mg of glucosamine and 400mg of chondroiton. It should be taken 3 times a day every day until the desired results are achieved at that point you can reduce the dose to once daily and in most cases you will be able to stop taking the ibuprofen. Just for the record it saved me from having a hip replacement when I was in my 30's and the results left my orthopedist in shock.
Question; " I suffer terribly every time I am bitten by a mosquito. I end up with welts the size of half dollars and all I want to do is scratch them until they bleed. Due you have any answers that could help?"
Answer; After a mosquito sucks your blood, the mosquito will leave its saliva in your body along with any bacterial or virus it may be carrying from a previous victim. This saliva will cause a histamine reaction. Depending on your bodies sensitivity you can develop anything from a small red bump to a huge welt. If you think that you have a good chance of being bitten by a mosquito I recommend using mosquito repellent as well as taking a long acting antihistamine each day such as Zyrtec or the generic cetirizine once a day and at the same time each day. If you are already using a mosquito repellent and taking the cetirizine and you notice you are bitten I recommend a remedy my grandmother who was also a pharmacist passed down to me. Take some Adolf's Meat tenderizer (or any generic form will suffice) pour a little bit onto a spoon, add a few drops of water and mix together until you have formed a thick paste (note it will be a little bit gritty) then apply the paste directly to the bite area. This will help remove the itching within minutes. If need be, cover the area with a bandage for no more than 2 hours just long enough to keep the paste on that area and be absorbed at the site of the bite. If the area is really itchy I suggest you rub an ice cube over the bite for 2-3 minutes prior to applying this mixture.
Question; "I have bad knees and take ibuprofen daily for the pain. I have had friends tell me about a compound called glucosamine does it really work."
Answer; The product you are looking for is a combination product called glucosamine-chondroiton. It should be noted that it is not a quick fix it can take up to three months before you begin to notice any changes in your joint linings or joint pain. For adults I recommend you buy a product that comes in a 5:4 ratio. You want to find a capsule formulation not a tablet which contains 500mg of glucosamine and 400mg of chondroiton. It should be taken 3 times a day every day until the desired results are achieved at that point you can reduce the dose to once daily and in most cases you will be able to stop taking the ibuprofen. Just for the record it saved me from having a hip replacement when I was in my 30's and the results left my orthopedist in shock.
Thursday, February 2, 2012
IN RESPONSE TO YOUR QUESTIONS PART TWO
Question; "After my last doctor's appointment my doctor wanted blood work done. I had the blood taken the next day and received a call from my doctor's office 2 days later telling me he wanted to see me that day if possible. Upon meeting with my doctor he told me my liver enzymes were outside normal limits and the test run indicated probable liver problems and pancreatitis. I admitted to being more than just a social drinker and due to the stress of keeping my job and my financial responsibilities in this economy I was drinking between 4-6 drinks after work daily and probably more on the weekends for the last 6 months. He told me to wake up and realize I was damaging almost every organ in my body, but for now he was most concerned with my pancreas and liver. He also told me that he was also surprised that I did not develop a stomach bleed drinking that much alcohol while taking naproxen. " ( a non-steroidal anti-inflammatory drug similar to ibuprofen) " I told him that I had not been taking the naproxen because it had been upsetting my stomach for the past few months so I was taking Tylenol in its place. That is when my doctor told me that was the worst possible thing I could have done. The combination of Tylenol" (acetaminophen) " and alcohol could cause both irreversible liver and kidney damage. My doctor told me I had to stop drinking immediately and stop taking Tylenol and he placed me on a drug called nabumetone for my knee. I have 2 questions. First will my pancreas heal my doctor said I could develop diabetes 2? Second do I have permanent liver damage or will my liver heal itself? I heard there was a product called thissle milk I could take that would help regenerate my liver like it was brand new, is this true and where can I get it?
Answer; The first thing you need to do is stop your alcohol consumption. If you are under that much stress ask your physician about prescribing an anxiolytic medication for a short time basis to relieve the stress and anxiety. This, although, is not a long term solution. You need to find an outlet, a hobby or interest to divert your attention from your anxiety or stress. If this doesn't work counseling maybe the answer. Your doctor was also right about ingesting alcohol and acetaminophen in the same time frame. It is a serious problem that the public should really be made aware of on a regular basis. I realize that you probably did this because taking the naproxen along with the alcohol was irritating your stomach lining but it was a serious error in judgement. As far as your pancreas is concerned if you were not hospitalized by your physician then chances are very good that your pancreatitis will go away if you discontinue the alcohol for a month. Chances that you develop Type II diabetes from this episode are probably very small, however, I am not your doctor and do not know what your physical state is at the present time or if you have any other contributing factors such as obesity or a family history of adult onset (Type II) diabetes. One thing is for sure though if you continue to drink like you are now, then you greatly increase the risk. As far as your second question there is no product available called thissle milk. There is however an herbal remedy called Silybum marianus commonly known as Milk Thistle. You want to make sure that this seed extract that contains at least 70% of the active ingredient silymarin. Milk Thistle is put out by many different manufacturers and is available in a capsule formulation. When the liver becomes compromised by alcohol it is important to boost its health and enhance remaining functioning liver. Milk Thistle works by rebuilding healthy liver cells, stimulating the production of toxin-neutralizing antioxidants while improving bile flow and minimizing liver-related complications. In addition, Dandelion and Verbena officinalis are used to benefit liver and digestive health. Natural remedies make a gentle yet effective alternative to liver health and vitality. Therefore, the answer to your second question is no. Once you have damaged liver cells you can not rejuvenate them. The key is to rebuild healthy liver cells that you still have enabling them to work at peak performance.
Question; "I am an easy bruiser do you know of anything that will quicken the time it takes for my bruises to go away."
Answer; If you know you are going to get a bruise on a specific area of your body, try icing the area right away or if you notice an unsightly bruise that you are looking to heal just a little bit quicker as well as alleviate some of the pain associated with it I recommend two homeopathic remedies the first is called arnica gel. Bruises hurt less and their color dissipates in about half the time. The second is called Comphrey ointment (it is a mixture of Tallow, Comprey Leaves, olive oil, beeswax, and peppermint oil).
Answer; The first thing you need to do is stop your alcohol consumption. If you are under that much stress ask your physician about prescribing an anxiolytic medication for a short time basis to relieve the stress and anxiety. This, although, is not a long term solution. You need to find an outlet, a hobby or interest to divert your attention from your anxiety or stress. If this doesn't work counseling maybe the answer. Your doctor was also right about ingesting alcohol and acetaminophen in the same time frame. It is a serious problem that the public should really be made aware of on a regular basis. I realize that you probably did this because taking the naproxen along with the alcohol was irritating your stomach lining but it was a serious error in judgement. As far as your pancreas is concerned if you were not hospitalized by your physician then chances are very good that your pancreatitis will go away if you discontinue the alcohol for a month. Chances that you develop Type II diabetes from this episode are probably very small, however, I am not your doctor and do not know what your physical state is at the present time or if you have any other contributing factors such as obesity or a family history of adult onset (Type II) diabetes. One thing is for sure though if you continue to drink like you are now, then you greatly increase the risk. As far as your second question there is no product available called thissle milk. There is however an herbal remedy called Silybum marianus commonly known as Milk Thistle. You want to make sure that this seed extract that contains at least 70% of the active ingredient silymarin. Milk Thistle is put out by many different manufacturers and is available in a capsule formulation. When the liver becomes compromised by alcohol it is important to boost its health and enhance remaining functioning liver. Milk Thistle works by rebuilding healthy liver cells, stimulating the production of toxin-neutralizing antioxidants while improving bile flow and minimizing liver-related complications. In addition, Dandelion and Verbena officinalis are used to benefit liver and digestive health. Natural remedies make a gentle yet effective alternative to liver health and vitality. Therefore, the answer to your second question is no. Once you have damaged liver cells you can not rejuvenate them. The key is to rebuild healthy liver cells that you still have enabling them to work at peak performance.
Question; "I am an easy bruiser do you know of anything that will quicken the time it takes for my bruises to go away."
Answer; If you know you are going to get a bruise on a specific area of your body, try icing the area right away or if you notice an unsightly bruise that you are looking to heal just a little bit quicker as well as alleviate some of the pain associated with it I recommend two homeopathic remedies the first is called arnica gel. Bruises hurt less and their color dissipates in about half the time. The second is called Comphrey ointment (it is a mixture of Tallow, Comprey Leaves, olive oil, beeswax, and peppermint oil).
Wednesday, February 1, 2012
IN RESPONSE TO YOUR QUESTIONS PART ONE.
First let me thank you for the questions I have received via e-mail, since I asked my readership if they had any concerns or healthcare issues I could shed some light upon.
QUESTION: "I am in the 1st trimester of my 3rd pregnancy and am experiencing all the signs of morning sickness you hear about, but they seem to be never ending. I have these symptoms what seems like 24 hours a day. I never had a problem with my 1st two pregnancies, why now and is there anything I can do to lessen these effects My OB told me that every pregnancy is different and did not have much to offer in the way of helpful advice. Is there anything you are aware of that I can take to help me feel better without endangering my baby.
ANSWER: My wife and I have 5 children and unfortunately she had terrible morning sickness with two of them. From the time she put her feet on the floor in the morning till the time went to bed at night. However, I found the cure that alleviated all of her symptoms without causing any harm to our unborn children. The answer was not a drug or a homeopathic remedy it was a device. The device is a pair of wrist brands called ACUBANDS. They work by acupressure (pressing down on a nerve ending on the wrist) to suppress all of the symptoms of morning sickness. They are mainly marketed for motion (sea, air, car) sickness. I've sold hundreds of pairs over my 30 year career and I swear by them. They would totally alleviate any and all signs of morning sickness within minutes after applying them. In fact, we had to have two pairs for her because she noticed when she took them off to shower or bathe her symptoms would return within minutes. Therefore she wore them while bathing would remove them afterwards and put on a dry pair allowing the other pair to air dry. I was so amazed by their effectiveness that I would tell my pregnant patients if they were not completely satisfied to return them and I would refund them double their purchase price. Just as a side note I never had a pair returned. These wrist bands are the only ones I ever recommended even though there many are similar products on the market. The reason for this is the design, it provides a perfect fit for any person every time. They retail for between $7.50 and $10.00 a pair. If you can not find them in your local pharmacy you can purchase them over the Internet.
PLEASE NOTE I HAVE NO FINANCIAL OR OTHER TIES TO THIS COMPANY OR THEIR PRODUCT AND RECEIVE NOTHING FOR MY ENDORSEMENT OF ACUBANDS OR ANY OTHER PRODUCT THEY MAY MAKE OR DISTRIBUTE.
Question: "I was recently at my local health food store and explained to the clerk that I was looking for a supplement to lower my blood pressure because I did not like side effects and the way I felt since my doctor had started me on a blood pressure medication. The clerk told me they carried a popular homeopathic capsule containing garlic, cayenne, and a few other supplements and that it would lower blood pressure and not cause the side effects I was experiencing. Is this true?"
Answer: Unfortunately, because this garlic-cayenne combination is a naturally occurring substance and it not patented by a major drug company. Without a patent it is worthless to a drug company to study and do clinical trials on patients because any drug company could copy or steal any useful information and market it themselves if it was thought to be of any benefit which means only monetary losses to the company who originally developed it and got FDA approval to market it as a drug. Therefore, most of these homeopathic plants or herbs are not considered drugs. They are considered homeopathic remedies or food supplements. Which are millions of dollars cheaper to place on the market under FDA guidelines.
Now to answer the question about the use of this remedy garlic and cayenne both can play an important role in dietary and exercise programs to help lower blood pressure. The combination can help strengthen the heart and improve circulation over a period of time it can also lower cholesterol. The big questions are to what extent and how long can the process take. The answer is that you probably can only expect a very minor drop in blood pressure and it could take weeks to months before it occurs.
Remember it is very important not stop taking what your doctor has prescribed. Depending on the medication stopping it abruptly could cause rebound hypertension. This is when your blood pressure could end up higher than it was when you started the medication. This could lead to a heart attack or stroke. There are hundreds of medications to control blood pressure a lot of the time it is just a matter of time trying to find the right fit for you.
I am a strong believer in alternative medicine including homeopathic and natural remedies. After all the practice of pharmacy and the use of medication owes its roots to plants that naturally occur in our environment. The drug digoxin ( "Digitalis" without question is the most valuable cardiac drug ever discovered and one of the most valuable drugs in the entire pharmacopoeia.) it is a drug derived from a plant that is responsible for saving millions upon millions of lives world wide who suffer from heart problems. Homeopathic remedies need to be looked at on an individual case basis.
Question: As a pharmacist what do you recommend for mucous and congestion?
Answer: My recommendation to alleviate a mucous problem consists of three things. First, cut out all dairy products (milk, cheese, etc.). Dairy products are mucous forming and do nothing but to add to the problem. Second, if not prohibited by any pre-existing medical conditions, such as problems with kidney function, edema (swelling), etc., then you need to increase your clear fluid intake. This means adding 6-8 glasses of clear fluids to your diet each day that you are experiencing a mucous problem. Third and most importantly is adding an over-the-counter medication known as guaifenesin which helps the body to break down the mucous and reabsorb it as fluid for excretion. Although, expensive I find the most effective form and least irritating to the stomach is Mucinex. This medication comes under many different names both brand and generic which are less pricey such as Robitussin and many generic forms. I find the extended release dosage forms to be most effective.
For congestion my primary recommendation is the over-the-counter drug pseudoephedrine. Pseudoephedrine can not be found on the shelf of a supermarket or pharmacy. It is kept behind the counter and you must have a driver's license to purchase this product due to state and federal regulations. This requirement is mandated since it was being use to make the illegal street drug crystal methamphetamine. If you have uncontrolled high blood pressure please check with your health care professional prior to use. My second recommendation although not as effective is a decongestant called phenylephrine. I do not recommend nasal sprays such as oxymetazoline nasal spray the active ingredient in Afrin nasal spray as well as others. Although, they work for a full 12 hours as a decongestant anything other that very short term use can lead to a physical dependence, as they dry the nasal passages out so much the body overcompensates by rehydrating these tissues with mucous making the condition even worse. This is also referred to as rebound congestion and if this occurs weaning off these products is very lengthy and uncomfortable process. Lastly, the two products I have recommended guaifenesin and pseudoephedrine are both safe to take during pregnancy.
Question: I wake up in the morning with dry, bloodshot, irritated eyes that feel like they are full of sand. I have used all types of eye drops any lubricating tear ointment prior to bedtime, but they don't seem to help my pharmacist looks like he is just out of school and has no answers for me. Have you ever heard of an allergy or condition like this one.
Answer: I can not be sure, but it sounds like you are suffering from blepharitis (dandruff of the eyelids specifically that area of skin around your top and bottom of your eyelashes). It is usually a seasonal condition and occurs much more often than you think. Flakes of skin exfoliate from the eyelash area and enter the eye(s) while sleeping. The body treats these flakes of skin as a foreign thus causing you to wake up with the symptoms you mentioned. Treatment is very easy and the condition can be cleared up in a few days. It can be treated agrressively with a tearless baby shampoo and cotton swabs. All you have to do is gently scrub the area of your eyelashes top and bottom after placing the shampoo on the end of the swab. Which debrides any loose skin from the area. Follow this by gently removing the shampoo with a warm washcloth. Finally, gently massage an artificial tear ointment to the external portion of the eye lashes. This will usually alleviate the condition within 2-3 days, However, it is a good idea to repeat this procedure at least once or twice a week once it has cleared. There is also a less aggressive form of therapy which usually takes 7-10 days two work, but must be maintained and repeated 3-4 days a week after the condition has cleared. there are eyes cleansing pads sold over-the-counter that not only debrede the loose skin from the area around the eyelashes but they also contain a moisturizer to help reduce the reoccurance of the condition. Although, the cleansing pads are more expensive and take a little longer for the results to occur you basically end up with the same outcome.
QUESTION: "I am in the 1st trimester of my 3rd pregnancy and am experiencing all the signs of morning sickness you hear about, but they seem to be never ending. I have these symptoms what seems like 24 hours a day. I never had a problem with my 1st two pregnancies, why now and is there anything I can do to lessen these effects My OB told me that every pregnancy is different and did not have much to offer in the way of helpful advice. Is there anything you are aware of that I can take to help me feel better without endangering my baby.
ANSWER: My wife and I have 5 children and unfortunately she had terrible morning sickness with two of them. From the time she put her feet on the floor in the morning till the time went to bed at night. However, I found the cure that alleviated all of her symptoms without causing any harm to our unborn children. The answer was not a drug or a homeopathic remedy it was a device. The device is a pair of wrist brands called ACUBANDS. They work by acupressure (pressing down on a nerve ending on the wrist) to suppress all of the symptoms of morning sickness. They are mainly marketed for motion (sea, air, car) sickness. I've sold hundreds of pairs over my 30 year career and I swear by them. They would totally alleviate any and all signs of morning sickness within minutes after applying them. In fact, we had to have two pairs for her because she noticed when she took them off to shower or bathe her symptoms would return within minutes. Therefore she wore them while bathing would remove them afterwards and put on a dry pair allowing the other pair to air dry. I was so amazed by their effectiveness that I would tell my pregnant patients if they were not completely satisfied to return them and I would refund them double their purchase price. Just as a side note I never had a pair returned. These wrist bands are the only ones I ever recommended even though there many are similar products on the market. The reason for this is the design, it provides a perfect fit for any person every time. They retail for between $7.50 and $10.00 a pair. If you can not find them in your local pharmacy you can purchase them over the Internet.
PLEASE NOTE I HAVE NO FINANCIAL OR OTHER TIES TO THIS COMPANY OR THEIR PRODUCT AND RECEIVE NOTHING FOR MY ENDORSEMENT OF ACUBANDS OR ANY OTHER PRODUCT THEY MAY MAKE OR DISTRIBUTE.
Question: "I was recently at my local health food store and explained to the clerk that I was looking for a supplement to lower my blood pressure because I did not like side effects and the way I felt since my doctor had started me on a blood pressure medication. The clerk told me they carried a popular homeopathic capsule containing garlic, cayenne, and a few other supplements and that it would lower blood pressure and not cause the side effects I was experiencing. Is this true?"
Answer: Unfortunately, because this garlic-cayenne combination is a naturally occurring substance and it not patented by a major drug company. Without a patent it is worthless to a drug company to study and do clinical trials on patients because any drug company could copy or steal any useful information and market it themselves if it was thought to be of any benefit which means only monetary losses to the company who originally developed it and got FDA approval to market it as a drug. Therefore, most of these homeopathic plants or herbs are not considered drugs. They are considered homeopathic remedies or food supplements. Which are millions of dollars cheaper to place on the market under FDA guidelines.
Now to answer the question about the use of this remedy garlic and cayenne both can play an important role in dietary and exercise programs to help lower blood pressure. The combination can help strengthen the heart and improve circulation over a period of time it can also lower cholesterol. The big questions are to what extent and how long can the process take. The answer is that you probably can only expect a very minor drop in blood pressure and it could take weeks to months before it occurs.
Remember it is very important not stop taking what your doctor has prescribed. Depending on the medication stopping it abruptly could cause rebound hypertension. This is when your blood pressure could end up higher than it was when you started the medication. This could lead to a heart attack or stroke. There are hundreds of medications to control blood pressure a lot of the time it is just a matter of time trying to find the right fit for you.
I am a strong believer in alternative medicine including homeopathic and natural remedies. After all the practice of pharmacy and the use of medication owes its roots to plants that naturally occur in our environment. The drug digoxin ( "Digitalis" without question is the most valuable cardiac drug ever discovered and one of the most valuable drugs in the entire pharmacopoeia.) it is a drug derived from a plant that is responsible for saving millions upon millions of lives world wide who suffer from heart problems. Homeopathic remedies need to be looked at on an individual case basis.
Question: As a pharmacist what do you recommend for mucous and congestion?
Answer: My recommendation to alleviate a mucous problem consists of three things. First, cut out all dairy products (milk, cheese, etc.). Dairy products are mucous forming and do nothing but to add to the problem. Second, if not prohibited by any pre-existing medical conditions, such as problems with kidney function, edema (swelling), etc., then you need to increase your clear fluid intake. This means adding 6-8 glasses of clear fluids to your diet each day that you are experiencing a mucous problem. Third and most importantly is adding an over-the-counter medication known as guaifenesin which helps the body to break down the mucous and reabsorb it as fluid for excretion. Although, expensive I find the most effective form and least irritating to the stomach is Mucinex. This medication comes under many different names both brand and generic which are less pricey such as Robitussin and many generic forms. I find the extended release dosage forms to be most effective.
For congestion my primary recommendation is the over-the-counter drug pseudoephedrine. Pseudoephedrine can not be found on the shelf of a supermarket or pharmacy. It is kept behind the counter and you must have a driver's license to purchase this product due to state and federal regulations. This requirement is mandated since it was being use to make the illegal street drug crystal methamphetamine. If you have uncontrolled high blood pressure please check with your health care professional prior to use. My second recommendation although not as effective is a decongestant called phenylephrine. I do not recommend nasal sprays such as oxymetazoline nasal spray the active ingredient in Afrin nasal spray as well as others. Although, they work for a full 12 hours as a decongestant anything other that very short term use can lead to a physical dependence, as they dry the nasal passages out so much the body overcompensates by rehydrating these tissues with mucous making the condition even worse. This is also referred to as rebound congestion and if this occurs weaning off these products is very lengthy and uncomfortable process. Lastly, the two products I have recommended guaifenesin and pseudoephedrine are both safe to take during pregnancy.
Question: I wake up in the morning with dry, bloodshot, irritated eyes that feel like they are full of sand. I have used all types of eye drops any lubricating tear ointment prior to bedtime, but they don't seem to help my pharmacist looks like he is just out of school and has no answers for me. Have you ever heard of an allergy or condition like this one.
Answer: I can not be sure, but it sounds like you are suffering from blepharitis (dandruff of the eyelids specifically that area of skin around your top and bottom of your eyelashes). It is usually a seasonal condition and occurs much more often than you think. Flakes of skin exfoliate from the eyelash area and enter the eye(s) while sleeping. The body treats these flakes of skin as a foreign thus causing you to wake up with the symptoms you mentioned. Treatment is very easy and the condition can be cleared up in a few days. It can be treated agrressively with a tearless baby shampoo and cotton swabs. All you have to do is gently scrub the area of your eyelashes top and bottom after placing the shampoo on the end of the swab. Which debrides any loose skin from the area. Follow this by gently removing the shampoo with a warm washcloth. Finally, gently massage an artificial tear ointment to the external portion of the eye lashes. This will usually alleviate the condition within 2-3 days, However, it is a good idea to repeat this procedure at least once or twice a week once it has cleared. There is also a less aggressive form of therapy which usually takes 7-10 days two work, but must be maintained and repeated 3-4 days a week after the condition has cleared. there are eyes cleansing pads sold over-the-counter that not only debrede the loose skin from the area around the eyelashes but they also contain a moisturizer to help reduce the reoccurance of the condition. Although, the cleansing pads are more expensive and take a little longer for the results to occur you basically end up with the same outcome.
Sunday, January 29, 2012
A Continuation On Communication (Side Effects And Allergic Reactions)
Some True Experiences Taken From
http://www.drugnet.com.hk/joke/joke_pharmaracy.html
One guy I worked with back in the early 80's tells of one patient and his med. Well you see some medication require that the patient not stop taking them without the advice of their MD, since sometimes the patient has to be weaned down on the dose slowly before they can get off the med.
One doctor had put on this patients prescription (and wanted it put into directions on the bottle) that the patient was not to stop taking the med abruptly.
So being a good pharmacist my fried typed the label: "Take one tablet twice a daily. Do not stop abruptly."
The patient gets his prescription and takes out the bottle and reads the label and comes back to the pharmacist and says I have a question.
Pharmacist says, "sure what can I do for you?" (being a good pharmacist we are ALWAY ready and willing any question posed by our patients).
The patient says I see here that the directions say "not stop abruptly" but what if something runs out in front of my car?
I'm sure glad this guy asked before heading home cause I'd have hated to have him go through his life slowing down while walking up to a corner or into a checkout line at the store. (actual source unknown)
Another pharmacist tells of kidding with one of his patient who took him seriously:
The pharmacist typed the label of an eye drop: "Place on drop in both eyes twice daily."
The patient got the prescription and read the label and asked? "How am I supposed to get the same drop in both eyes? How do I get a half a drop?"
Okay, my friend figures he this guy has got to be kidding so he tells him how to do it. Do you know? Well it is something they don't teach you pharmacy school...but this guy had an answer. He said, "Well first you get a razor blade and position it up between your eyes. Then you take the dropper and get one drop on the end of the dropper and kinda flip the drop up in the air. When it comes down you get underneath it and make sure it hits the razor blade right in the middle. The 2 halves of the drop will go into each eye at the same time."
to which the patient replies straight faced and serious, "I don't think I can do that". Makes you worry about where these pharmacist work and you'll ever have to encounter them on the other side of the counter some day. (Actual source unknown)
All I know is if this pharmacist worked for me, he or she would have been seeking new employment the next day.
Please forgive the spelling and grammar I pulled these stories as is from the above referenced web site.
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Sharing another personal experience.
I just wanted to share one more story of the many that have happened to me over the course of my career. I will share more of these stories with you in future blogs if I feel they are appropriate and tie into the topic I am blogging about.
I was just out of pharmacy school and working at my cousin's pharmacy on Saturdays. I had a woman come into me to complain about the prescription she had filled two days earlier. The prescription was for promethazine suppositories and the directions the pharmacist typed on the label read "Remove foil prior to using one suppository four times a day for nausea and vomiting." The problem she had was two fold, First she said they were not very effective and second they were to large and had to be chewed before she was able to swallow them. She explained that not only did they taste bitter and make her want to vomit, but they were leaving a waxy paste all over her teeth and wanted to know if we sold a special toothpaste or a toothbrush with stronger bristles to remove the wax from her teeth. I apologized to her explaining that the pharmacist should have explained that the suppositories were to be inserted rectally not orally. First I assured her that taking it this way although not as effective it would not hurt her in any way. Then I apologized to her explaining that the pharmacist should have explained to her that they were to be inserted rectally when she picked them up. Even though not typed on the label the words "for rectal use only" was printed twice in bold letters on the box. She said it was not really are fault because her husband picked them up on his way home from work and did not bother to ask any questions of the pharmacist because he was rushing to get the medication home to his wife.
I learned a valuable lesson that day. First always apologize to the patient no matters who is at fault and never take the defensive position. It helps calm the patient down and let them know that you are empathetic to their needs and concerns. The second was never take anything for granted when it came to the wording on the prescription label, e.g. "Remove foil or wrapper prior to inserting one suppository rectally (,vaginally, etc.) four times a day as needed for nausea or vomiting."
Remember always ask questions! If you feel uncomfortable about asking questions on the spot, like when picking up your prescription(s), then go home carefully read the information (monograph(s)) supplied by law with each prescription. The Monograph contains information you should know about medication(s) you have picked up. Next, make up a list of questions so you are prepared and know precisely what information you want to be clear about. Call your health care professional and ask for a few minutes to clarify the information you have been given. No question is to trivial or inconsequential when it comes to understanding your health care concerns. If your health care professional makes you feel like you are waisting his or her time or makes you feel like you question is trivial or ridiculous it is time to find a new health care professional. Being a great health care professional is only part of the equation the second part is one that takes a true genuine interest in their patients. It may sound like I took it a little bit too far, but during the seventeen years I owned and operated my pharmacy I would try attend either the viewing or funeral service of each of my patients that past away. I would send little baby baskets (with powder, lotion shampoo, etc.) to the families of newborns and send a get well cards to those who were sick. It is your body and you should feel comfortable about how and who you are being treated by and what treatment course(s) you are being asked to follow or medication(s) you are ingesting.
It is important to remember that a lot of times there is an initial adjustment period where you may experience side effects when starting a new course of therapy, a new medication, or a regimen of medications. It is always a good idea to check with your pharmacist or doctor to check if these initial side effects will pass or if they are something you will be able to live with. Most times the body will adjust to side effects of a new medication or medication, other times it can be as simple as having your doctor make a dosage adjustment.
However, sometime these side effects can not be alleviated and that is when you need to talk to your pharmacist or doctor about alternatives. Many times it is just a matter of finding a different medication in that category of drugs that does not produce the side effect you're experiencing. Remember, this not only corrects the disease state being treated, but it does not detract from your quality of life. This in turn enhances compliance and your health.
Knowing the difference between a side effect and an allergic reaction.
Allergic reactions is your bodies immune systems attempt to reject a substance it considers foreign and dangerous to your body. Whether it be pollen from a plant or flower, pet dander, a fruit or food, an insect or animal bite, a medical treatment modality, a chemical, or drug. The list of things that people can be allergic to are endless. An allergic reaction can also happen at anytime when coming in contact with allergic substance (antigen). For example you could eat citrus fruit all of your life thousands of times over with no reaction and then one day out of the blue you could develop an allergic reaction to citrus fruit. The same with medication you could take penicillin fifty different times then on the fifty first encounter you could suffer from an allergic reaction. Although, it is uncommon it does occur. However, let me make it clear that if you are taking a maintenance medication every day this is something that would not occur. It is rare and only seen when there have been extended periods of time between when the medication is given. It is very important to be able to determine between side effects and allergic reactions such as rashes, itching, and swelling of various body parts (like your lips, gums, tongue, throat, or extremities), changes in vision or shortness of breath. These are common allergic reaction, but are not all of the allergic reaction that can occur so make sure to check the information that accompanies each prescription you receive. The life you save could be your own. It is always a good idea to keep a quick acting as well as a short acting antihistamine on hand at home when starting a new prescription or over the counter medication. Benadryl (diphendydramine HCl) is my preference. Allowing that you do not have any pre-existing conditions which preclude you from taking the antihistamine, then at the first sign of what you perceive to be allergic reaction take the doseage of the antihistamine prescribed on the bottle or box. Then use your best judgement in determining whether to call your pharmacist, doctor, 911, or head for the nearest emerganency room.
EDUCATE YOURSELF, KNOWLEDGE IS POWER AND THAT POWER CAN NOT ONLY INCREASE THE QUALITY OF YOUR LIFE, BUT IT COULD EVEN SAVE YOUR LIFE OR THAT OF A LOVED ONE.
Friday, January 20, 2012
SAD
SAD; Seasonal Affective Disorder
It is the time of year that Seasonal Affective Disorder usually affects millions of people worldwide. Seasonal Affective Disorder or SAD as it is prominently referred to more than adequately describes this condition. SAD is a mood disorder that is also known as winter or summer depression or more commonly as the "Winter Blues" or "Summertime Blues". It usually effects women more than men and the people effected have normal mental health most of the year, but experience this depression in the winter months sometimes overlapping into the spring time and rarely instances occur during the summer months. If this condition occurs during the summer months it is usually referred to as reverse SAD and can be accompanied by heightened feelings of anxiety along with the depression. Some studies have linked it with bipolar depression. There are several symptoms that differentiate this mood disorder from other types of depression.
- Difficulty waking up in the morning Wanting to sleep all of the time.
- A tendency to oversleep and over eat.
- Weight gain usually caused by an increased craving for carbohydrates.
- A lack of energy and a problem finishing tasks.
- Withdrawal from family and friends as well as social events.
- A decreased libido (decreased sex drive).
All of these lead to a poor outlook on life generally leading to further depression. These seasonal variations in mood are thought to be directly related to light. That's right, this mood disorder can be correlated with the exposure to diminished sunlight. That is why it usually occurs during the winter months when the sun appears for a shorter period of time in the sky. As, the days are shorter during these months the cases increase. The incidents also increase in numbers as people live further away from the equator. Studies in the United States show its incidents effects less than 1.5% of the population, while people who live in New Hampshire and Vermont have an incidents of over 7.5%. Other studies have shown the incidents to be over 14% in Nordic Countries.
Treatment for seasonal affective disorder tries to deal with the symptoms that initiate the disorder which include, but are not limited to light therapy (phototherapy), psychotherapy and medications. Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year. Remember there are treatment modalities. Reiterating there are treatments such as light box therapy, ionized-air administration, prescription supplementation of the (OTC) hormone melatonin which should only be performed by a qualified physician who has specific knowledge as to the dosage and time it needs to be administered as well as a few specific prescription drugs and homeopathic medications, and behavior modification. It is my recommendation that you talk to you healthcare professional or have them refer you to a specialist. I also recommend that you perform your own search on the Internet to obtain valuable information that this article has not included. Who knows it could save your life or enhance the quality of care your are looking for. Remember never try to treat yourself. See you primary care physician explaining all your symptoms and let him see if you need to be referred to a specialist to treat this condition. Do not let your your doctor diagnose you and dismiss the symptoms you have explained to him or her. If you do not feel comfortable it is your right to be referred to a specialist.
Wednesday, January 18, 2012
Suggestions And Tips For Picking A Primary Care Physician
Suggestions and Tips for Picking A Primary Care Physician
The first thing you must decide is the type of doctor you are looking for in a primary care physician (PCP). They generally fall under three categories; general practitioners, family practitioners, and internists.
General Practitioners are family practice doctors who have received their training before Family Practice became a certifiable specialty with specific training requirements. They are also doctors who may include osteopaths and are more likely to not have board certification depending on state laws and requirements.
Family Practitioners are certified or are board eligible in the specialty of Family Practice and have completed specific training in Family Medicine. They treat patients of all ages from infants to geriatric adults. They are able to treat widespread illnesses and conditions, including those sometimes treated by specialists.
Internist are certified or board eligible and have completed specific training in the specialty of Internal Medicine. They usually only treat adults and although they treat a wide variety of medical conditions, they usually don't treat more serious conditions that require specialized care.
Please note that I have purposely left out Pediatricians for all of you adults with children and plan on covering that topic later.
Now that you have a basic understanding of the types of doctors to choose from the next thing to do is to narrow the list down to fit your specific needs.
First you have to look at your general state of health and determine which type of doctor best fits your needs. For instance if you had a wide array of medical problems you may be better served by a Family Practitioner rather than an internist who may likely refer you to different Specialists to treat your various disease states, thus increasing your out of pocket expenses (copays, deductibles, etc.).
The question then arises about healthcare insurance do you have an HMO or PPO, do you have major medical or are you covered by medicare or medicaid or even a state funded program and unfortunately there are those of us who have to pay out of pocket. These monetary factors have a definite impact on the medical care you are able to access. Now it is time to look at a list of physicians that are available to you under your insurance carriers. Narrow the list down by talking to friends and relatives in the area. However, my advice is look for a local independent pharmacy in your area and go in and ask the the pharmacist if he or she could spend a few minutes with you that you are looking for a new pharmacy and a new doctor. Ask him or her for their recommendation. Remember, these pharmacist deal with these doctors every day and know a lot of them personally as well as how their patients feel about them. I owned and operated my own pharmacy for seventeen years and each week I would stop into a different doctors office before work with a box of donuts and free samples trial size hand lotions, etc. for the staff. Granted I only got into see the doctor about three out of each five visits, but I got a feel for how the office was run and operated. Then as the years went on I was able to develop a relationship with these doctors and felt very comfortable about which doctors I recommended to patients when asked. Let me stress, however, ask an independent pharmacist this question, not a chain store pharmacist who has no stock in getting to know the doctors in their area. The other thing an independent pharmacist gets to know is each and everyone of his patients by name their medical histories and the relationships they have with their doctors both likes and dislikes. An independent pharmacist must get to know all his patients personally. They are the people who keep him in business. Believe me when I say they take an interest their patients, their patients' families and of course their patients' doctors. Otherwise, their doors don't stay open very long competing with the big chain drug stores. These independent pharmacist hold a wealth of knowledge and are willing to share that knowledge with you as long as it does not violate any of the HIPPA regulations.
You have now narrowed your list of potential primary care physicians. The next thing is to determine if they are still taking new patients if so ask the following questions to the receptionist over the phone when contacting them about becoming a new patient.
1. Does the doctor see patients in more than one office? (Are all the offices convenient to either your home or office.)
2. If you need to be seen quickly and your doctor is practicing at another office that day does he have a partner or partners that can see you in the office that is most convenient for you that day.
3. Are you going to actually see your doctor or are you going to spend most of your appointments visiting with a nursing practitioner or physicians assistant.
4. Does your doctor take emergency calls after hours or have someone "on call" to take your calls in case of an emergency. Try calling the office after hours. If you do get a recording that states "If this is a true medical emergency please hang up and call 911 or go to the nearest emergency room". Scratch that doctor off your list.
Now the final step involves making a visit to the doctor's office you have chosen;
1. Sit down in the waiting room for about 15 to 30 minutes and observe how long patients are waiting to be seen and do they look distraught or frustrated when exiting the office?
2. Watch the staff do they seem happy, are they attentive and organized and are the phones answered in a reasonable amount of time?
3. Next approach the receptionist tell her you looking for a new doctor and ask the following questions. How far in advance do I usually need to schedule an appointment and would the doctor be able to squeeze me in the same day if I had an emergency? What days and times does the doctor see patients? Who provides care in the doctor is absent? What hospital does the doctor admit patients to? And Lastly, can I set up an introductory visit with the doctor?
If all has gone according to plan you have found your new doctor, but if you feel at all uncomfortable or you don't communicate well during your introductory visit with your new PCP then start looking for a new one. Most insurance providers allow you to switch PCP in the 1st year more than once until you feel comfortable with the choice you have made.
Tuesday, January 17, 2012
Communication is Key
A majority of problems occur in healthcare when there is a breakdown in communication. Always make sure that you and your healthcare provider are on the same page. Unfortunately, there are many healthcare professionals out there (doctors, dentists, pharmacists, and nurses) who take for granted that you understand everything they communicate to you. However, whether they use words you don't quite understand or they speak too fast, not giving you ample time to process the information they are relaying can lead to disastrous results. Remember, your complete understanding of what your healthcare provider has told you is vital to the best possible outcome from your time together. Also remember, no question is too stupid to ask. Especially, if you do not completely understand the information you have been given. Never feel embarrassed or ashamed if you do not understand your consultation with your medical provider. ASK, ASK, and ASK again until you comprehend what has been conveyed to you. If anyone should be embarrassed, it should be your healthcare professional for not being able to adequately relay information to you in a language that you can understand. If this is the case, I recommend finding a healthcare provider who you can relate to and has the time and compassion to make sure your needs, knowledge, and concerns are met. After all, who is paying who? This is your health being discussed. I understand that in this world of HMOs and PPOs, doctors are under time constraints also and have to squeeze as many patients in as possible as the insurance companies have cut their reimbursement; but, if they don't have enough time for you, they should have a support system in place to make sure all your questions are not only answered, but understood.
I would like to refer to two true stories that are both funny and sad that occurred because of a simple miscommunication and a minor misunderstanding.
The first happened to my father-in-law, a physician. This incident occurred in his clinic. He treated a patient with a respiratory tract infection and upon discharging her, he gave her a prescription and told her to take it four times a day for 10 days. Then six days later, the woman returned to the clinic telling my father-in-law that she was almost out of medicine and needed more to last her the ten days. My father-in-law exclaimed, "I prescribed enough medication for the pharmacy to dispense for 10 days". At this point, she pulled out a small piece of paper from her pocket. She said, "This is all the medication I have left". She never took the prescription to the pharmacy to fill. She thought the prescription paper itself was the medication and had been tearing off a piece of it four times a day and eating it. Sad but true!
The second happened to me about seven years ago. I had a patient come in to my pharmacy with a question about an anti-fungal cream that her physician prescribed a few days earlier. She was on her way to Florida and wanted to know if it was okay to take the cream with her and apply it while she was away on vacation. I told her yes, that her doctor wanted her to use it for a 14 day period. She then explained to me that her doctor directed her to apply the medication "locally" three times a day and she was concerned because she was going outside of her local area. Her understanding was that she only had to apply it while she was at home. Again sad, but true.
Remember communication and understanding are key when it comes to positive outcomes in healthcare.
I would like to refer to two true stories that are both funny and sad that occurred because of a simple miscommunication and a minor misunderstanding.
The first happened to my father-in-law, a physician. This incident occurred in his clinic. He treated a patient with a respiratory tract infection and upon discharging her, he gave her a prescription and told her to take it four times a day for 10 days. Then six days later, the woman returned to the clinic telling my father-in-law that she was almost out of medicine and needed more to last her the ten days. My father-in-law exclaimed, "I prescribed enough medication for the pharmacy to dispense for 10 days". At this point, she pulled out a small piece of paper from her pocket. She said, "This is all the medication I have left". She never took the prescription to the pharmacy to fill. She thought the prescription paper itself was the medication and had been tearing off a piece of it four times a day and eating it. Sad but true!
The second happened to me about seven years ago. I had a patient come in to my pharmacy with a question about an anti-fungal cream that her physician prescribed a few days earlier. She was on her way to Florida and wanted to know if it was okay to take the cream with her and apply it while she was away on vacation. I told her yes, that her doctor wanted her to use it for a 14 day period. She then explained to me that her doctor directed her to apply the medication "locally" three times a day and she was concerned because she was going outside of her local area. Her understanding was that she only had to apply it while she was at home. Again sad, but true.
Remember communication and understanding are key when it comes to positive outcomes in healthcare.
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