By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
I am a lazy parent. I have been known to complain about helping my daughter with homework assignments. I go to work all day, then to meetings, then I try to scoff down some supper and then the teacher wants me to read with my kid before bedtime. A few times a year the teacher wants me to rearrange my schedule to come meet with them and talk about my kid. Why can't they just do this teaching stuff without me? Why do I have to go to parent teacher interviews? Why do I have to be involved in my child's education at all? I don’t really want to put in the effort. As I said, I am lazy.
The answer is that the more effort I put in, the more my child will learn. So if I get my butt off the couch, it will take less time and aggravation to stuff knowledge into my kid's head. How does this apply to my life in the pharmacy? I am going to give you three tips that will take a little effort on your part, but will save you time and aggravation in the pharmacy. Give the pharmacist your name. Know the names and prescription numbers of your medications. Call your medications in ahead of time.
Everyday in the pharmacy, someone walks up to me and says, "Fill my medicines. Its in the computer” even before they say hello. Even if you have been coming to the pharmacy for years, please start by giving me your name. I know the pharmacists and staff are familiar to you, but we see hundreds of faces in the store everyday. Do you ever get that feeling that you know someone’s face, but can’t place their name? That is an everyday occurrence at the pharmacy for me. It really will speed up your service if you start by telling me your name.
It is also very helpful if you give me a list of your medications, instead of saying, “It’s in the computer.” It will help you to know the names of your medications, so you will be better able to talk to your doctor. It will help me because although your file is “In the computer” I don’t always know what medications you are actually taking. Are you still taking that pain pill the doctor gave you 3 months ago? What about that inhaler you got last summer? Are you still taking it or not? I don’t really know unless you tell me. I know prescription medication names can be long and complicated. However, please feel free to ask us at the pharmacy to write you out a card with all the names on it. While I am writing out the card, you can tell me if you are still taking those medications. That way we both will have a better idea what you are taking.
All pharmacies will print a prescription number on your medications. It is the number with the largest print on the top of the label. This number is very helpful to you and me. If you phone in the prescription number, I can find out who you are and which medication you want. There are a couple of common misconceptions with prescription numbers, though. If you give me just a prescription number from a pharmacy in Winnipeg, it doesn’t help me at all. Prescription numbers are store specific. Prescription numbers also don’t help doctors. If you tell your doctor the prescription number on your bottle, you will get a blank stare. Doctor’s can’t look up your pharmacy files from their office. So knowing the prescription numbers and the names of your medications is very important.
Doctors and pharmacists don’t like the guess “my small yellow pill” game. The doctors will know what a few prescription medications look like, but not all of them. I know what more of the pills look like because I look at pills all day long. However, you will stump me every time with the guess “my round white pill” game. Do you know how many round white pills there are out there? So bring you doctor or pharmacist a written list of you medications or the original pill bottles.
Call a list of your medications into the pharmacy before you come down. Of course we can and do fill prescriptions when you are waiting in the store. But instead of waiting for me to figure out who you are, which medications you want and then filling them, wouldn’t it be nice if you could just walk into the store, pick up your already filled prescriptions and leave? I’ll do you one better. If you call in your list of medications, I can deliver them to you in Dauphin. If you live on our rural courier route, I can get them to your town. You don’t have to come to the store at all if you don’t want.
I know I am asking for some effort on your part. And if you don’t want to learn the names of your drugs, or what a prescription number is, that is okay too. I am getting pretty good at “Fill my prescriptions. They’re in the computer” and at figuring out which one is that “Round white pill.” Just like the teachers will still teach my kid even if I never lift my butt cheeks off the couch to help her. However, if I put in some effort and help my child with her homework and assignments, she will get knowledge stuffed in her head with less time and aggravation. If you get a pharmacist to make a list of your medication names, know your prescriptions by name and number, and call your order in ahead of time we can help you get in and out of the pharmacy with less time and aggravation.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Friday, March 27, 2009
Friday, March 20, 2009
CAFFEINE
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Way back in pharmacy school, I went home to Pinawa, Manitoba for the weekend. By Saturday night I had a horrible headache. I was really worried because I don’t normally get headaches. Did I have a tumor? What was wrong with me? My mother asked when I last had a cup of coffee. Turns out I hadn’t had one in about 24 hours. I was in caffeine withdrawal. My mom gave me a cup of coffee and I was fine. So much for me being a future finder of drug related problems.
I told this story once and got another pharmacist-coffee story. This pharmacist started developing a tremor. Their hands were shaking at work. They got very concerned and went to the doctor. The doctor was about to prescribe a medication for tremor, when the doctor asked, “How much coffee do you drink?” The answer was about 12-13 cups a day. The doctor put down their prescription pad and recommended cutting back on the coffee. The tremor went away.
So, even pharmacists often forget that caffeine is the most popular drug in the western world. It has been estimated that 80% of us consume caffeine. As a pharmacist, I find caffeine interesting. To begin with caffeine has a half life of six hours. We say it takes about 5 half lives for a drug to leave the body. That means it takes 30 hours (almost 2 days) for that cup of coffee to leave my body completely. Since I never take a two day break from coffee, that means I always have caffeine in my system. So, for example, caffeine is always making my blood pressure a little higher than normal.
Health Canada says :
· The general population of healthy adults is not at risk for potential adverse effects from caffeine if they limit their caffeine intake to 400mg per day(that is 3-4 cups of coffee per day);
· People who get an adequate daily amount of calcium have greater protection against the possible adverse effects of caffeine on bone health.
· Compared to the general adult population, children are at increased risk for possible behavioural effects from caffeine; and
· Women of childbearing age are at increased risk of possible reproductive effects if they consume caffeine.
Yes, I drink more coffee than Health Canada recommends. I probably go over my daily limit before I get to work in the morning. So what does that put me at risk of? Things like muscle tremors, nausea, irritability, high blood pressure, racing heart, thin bones and anxiety.
Caffeine was in the news again lately because of so-called energy drinks. These have names like “Red Bull”, “Monster”, “Rock Star” and many, many others. Health Canada specifically mentions not to drink more than 500 ml or 2 cans of Red Bull per day. In early March 2009 the Medical Society of PEI, told its legislature that these energy drinks should be banned from sale to minors. The argument is the PEI doctors are seeing racing hearts, anxiety, high blood pressure and sleeping problems in young people that they blame on the caffeine in these energy drinks. These energy drinks may have up to 300 mg of caffeine (2-3 cups of coffee) per can. Since Health Canada says adults should have less than 400 mg of caffeine (3-4 cups of coffee) per day and children 10-12 years old should have less than 85 mg of caffeine per day, you can see why a drink that has 300 mg of caffeine in one can could be a problem.
Dehydration is another problem with these energy drinks. Caffeine is a diuretic so it makes you lose water. That is one of the reasons why all the warnings not to mix energy drinks like Red Bull with alcohol. Alcohol is also a diuretic. So, if you mix caffeine with alcohol and then throw in exercise like dancing, all three cause you to lose water. If you lose too much water, it can damage your kidneys and if you get very dehydrated your blood gets too thick to pump. That can be fatal.
Caffeine is not all bad. There are studies saying caffeine does good things. There are studies saying caffeine protects you from getting colon cancer. There are studies saying that caffeine can prevent diabetes. Just to keep things confused though, another study says if you have diabetes already, consuming caffeine can make it harder to control your blood sugar. The take home message is probably one of moderation. Adults should stay under 4 cups of coffee per day. Children should consume one or less cans of caffeinated pop per day. I should try to get closer to Health Canada’s recommendation. Maybe. I’ll let you know how that goes.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Way back in pharmacy school, I went home to Pinawa, Manitoba for the weekend. By Saturday night I had a horrible headache. I was really worried because I don’t normally get headaches. Did I have a tumor? What was wrong with me? My mother asked when I last had a cup of coffee. Turns out I hadn’t had one in about 24 hours. I was in caffeine withdrawal. My mom gave me a cup of coffee and I was fine. So much for me being a future finder of drug related problems.
I told this story once and got another pharmacist-coffee story. This pharmacist started developing a tremor. Their hands were shaking at work. They got very concerned and went to the doctor. The doctor was about to prescribe a medication for tremor, when the doctor asked, “How much coffee do you drink?” The answer was about 12-13 cups a day. The doctor put down their prescription pad and recommended cutting back on the coffee. The tremor went away.
So, even pharmacists often forget that caffeine is the most popular drug in the western world. It has been estimated that 80% of us consume caffeine. As a pharmacist, I find caffeine interesting. To begin with caffeine has a half life of six hours. We say it takes about 5 half lives for a drug to leave the body. That means it takes 30 hours (almost 2 days) for that cup of coffee to leave my body completely. Since I never take a two day break from coffee, that means I always have caffeine in my system. So, for example, caffeine is always making my blood pressure a little higher than normal.
Health Canada says :
· The general population of healthy adults is not at risk for potential adverse effects from caffeine if they limit their caffeine intake to 400mg per day(that is 3-4 cups of coffee per day);
· People who get an adequate daily amount of calcium have greater protection against the possible adverse effects of caffeine on bone health.
· Compared to the general adult population, children are at increased risk for possible behavioural effects from caffeine; and
· Women of childbearing age are at increased risk of possible reproductive effects if they consume caffeine.
Yes, I drink more coffee than Health Canada recommends. I probably go over my daily limit before I get to work in the morning. So what does that put me at risk of? Things like muscle tremors, nausea, irritability, high blood pressure, racing heart, thin bones and anxiety.
Caffeine was in the news again lately because of so-called energy drinks. These have names like “Red Bull”, “Monster”, “Rock Star” and many, many others. Health Canada specifically mentions not to drink more than 500 ml or 2 cans of Red Bull per day. In early March 2009 the Medical Society of PEI, told its legislature that these energy drinks should be banned from sale to minors. The argument is the PEI doctors are seeing racing hearts, anxiety, high blood pressure and sleeping problems in young people that they blame on the caffeine in these energy drinks. These energy drinks may have up to 300 mg of caffeine (2-3 cups of coffee) per can. Since Health Canada says adults should have less than 400 mg of caffeine (3-4 cups of coffee) per day and children 10-12 years old should have less than 85 mg of caffeine per day, you can see why a drink that has 300 mg of caffeine in one can could be a problem.
Dehydration is another problem with these energy drinks. Caffeine is a diuretic so it makes you lose water. That is one of the reasons why all the warnings not to mix energy drinks like Red Bull with alcohol. Alcohol is also a diuretic. So, if you mix caffeine with alcohol and then throw in exercise like dancing, all three cause you to lose water. If you lose too much water, it can damage your kidneys and if you get very dehydrated your blood gets too thick to pump. That can be fatal.
Caffeine is not all bad. There are studies saying caffeine does good things. There are studies saying caffeine protects you from getting colon cancer. There are studies saying that caffeine can prevent diabetes. Just to keep things confused though, another study says if you have diabetes already, consuming caffeine can make it harder to control your blood sugar. The take home message is probably one of moderation. Adults should stay under 4 cups of coffee per day. Children should consume one or less cans of caffeinated pop per day. I should try to get closer to Health Canada’s recommendation. Maybe. I’ll let you know how that goes.
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Friday, March 13, 2009
ALZHEIMER'S DISEASE
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Have you ever said, “I can’t find my keys. I must be getting Alzheirmer’s?” Forgetting where you put your car keys, is not a sign of Alzheimer's disease. Forgetting how to drive you car may be a sign. In fact, if you have Alzheimer's disease, you may not notice you have it at all. However, close family and friends may notice that you sometimes forget things to do with time and place like where you live, and that your personality has changed.
It is estimated 500,000 Canadians have Alzheimer's disease or related dementia. Over 50,000 of them are under the age of 60. Women make up almost 75% of the group. As the baby boomers age, we expect the number of people in Canada with Alzheimer’s disease to double.
Alzheimer’s disease is the most common form of dementia. Dementia is a condition with symptoms like loss of memory, poor judgement and reasoning, changing moods and change in ability to talk and communicate. Alzheirmer’s disease was discovered by Dr. Alois Alzheimer in the early 1900’s. He found plaques and tangles in the brains of some dementia patients after they died. These are still the hallmarks of the disease doctors look for when confirming Alzheimer’s disease after the death of the patient.
In Alzheimer's disease, brain cells die. The result is of loss of memory and cognitive functioning. One key brain chemical, acetylcholine, appears to be in short supply in Alzheimer’s disease. Many drugs used to treat Alzheimer's disease are aimed at increasing the amount of acetylcholine in the brain.
Cholinesterase is an enzyme that breaks down acetylcholine. Drugs that inhibit this enzyme will leave more acetylcholine in the brain. The first cholinesterase inhibitor to gain wide scale use in Canada was donepezil or Aricept. We now also have rivastigmine or Exelon and galantamine or Reminyl. All three of these are cholinesterase inhibitors and they are indicated for mild to moderate Alzheimer’s disease.
Memantine or Ebixa is a little different. It is called an NMDA receptor antagonist. It works on a different brain chemical called glutamate. It is approved for use in moderate to severe Alzheimer’s and can be used with Aricept.
Here is the bad news. None of these medications is a cure. None of these medications will stop the disease from progressing. The best any of these medications can do is help manage symptoms and help maintain a person’s functioning for as long as possible. I see a lot of false hope in the pharmacy that these medications will “fix” a loved one with Alzheimer’s. They won’t. And these medications are expensive and not always covered by Manitoba Health.
The future for Alzheirmer’s may be brighter, though. The researchers are learning more about how to prevent the dementia. One thing from the research I found interesting is that preventing concussions and head injuries in the young may help those people to avoid dementia when they are older. And there is research happening today that we hope will produce treatments in 5 to 10 years that may be able to slow and stop the progression of Alzheimer’s disease.
For more information see: Alzheimer’s Society of Canada www.alzheimers.ca
As always if you have any questions or concerns about these or other products, ask your pharmacist.
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Have you ever said, “I can’t find my keys. I must be getting Alzheirmer’s?” Forgetting where you put your car keys, is not a sign of Alzheimer's disease. Forgetting how to drive you car may be a sign. In fact, if you have Alzheimer's disease, you may not notice you have it at all. However, close family and friends may notice that you sometimes forget things to do with time and place like where you live, and that your personality has changed.
It is estimated 500,000 Canadians have Alzheimer's disease or related dementia. Over 50,000 of them are under the age of 60. Women make up almost 75% of the group. As the baby boomers age, we expect the number of people in Canada with Alzheimer’s disease to double.
Alzheimer’s disease is the most common form of dementia. Dementia is a condition with symptoms like loss of memory, poor judgement and reasoning, changing moods and change in ability to talk and communicate. Alzheirmer’s disease was discovered by Dr. Alois Alzheimer in the early 1900’s. He found plaques and tangles in the brains of some dementia patients after they died. These are still the hallmarks of the disease doctors look for when confirming Alzheimer’s disease after the death of the patient.
In Alzheimer's disease, brain cells die. The result is of loss of memory and cognitive functioning. One key brain chemical, acetylcholine, appears to be in short supply in Alzheimer’s disease. Many drugs used to treat Alzheimer's disease are aimed at increasing the amount of acetylcholine in the brain.
Cholinesterase is an enzyme that breaks down acetylcholine. Drugs that inhibit this enzyme will leave more acetylcholine in the brain. The first cholinesterase inhibitor to gain wide scale use in Canada was donepezil or Aricept. We now also have rivastigmine or Exelon and galantamine or Reminyl. All three of these are cholinesterase inhibitors and they are indicated for mild to moderate Alzheimer’s disease.
Memantine or Ebixa is a little different. It is called an NMDA receptor antagonist. It works on a different brain chemical called glutamate. It is approved for use in moderate to severe Alzheimer’s and can be used with Aricept.
Here is the bad news. None of these medications is a cure. None of these medications will stop the disease from progressing. The best any of these medications can do is help manage symptoms and help maintain a person’s functioning for as long as possible. I see a lot of false hope in the pharmacy that these medications will “fix” a loved one with Alzheimer’s. They won’t. And these medications are expensive and not always covered by Manitoba Health.
The future for Alzheirmer’s may be brighter, though. The researchers are learning more about how to prevent the dementia. One thing from the research I found interesting is that preventing concussions and head injuries in the young may help those people to avoid dementia when they are older. And there is research happening today that we hope will produce treatments in 5 to 10 years that may be able to slow and stop the progression of Alzheimer’s disease.
For more information see: Alzheimer’s Society of Canada www.alzheimers.ca
As always if you have any questions or concerns about these or other products, ask your pharmacist.
Friday, March 06, 2009
SINUSITIS
By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Is your nose stuffed up and does your head hurt? Are you having trouble breathing and sleeping? Do you feel tired and have trouble hearing? Have you ever felt like that? All of us have felt this way at one point or other and it is unpleasant and a lot of us (including myself) have gone to the doctor and demanded an antibiotic. Well, we may not be doing ourselves any favors.
Sinusitis is an inflammation of the sinuses around the nose (paranasal sinuses). The paranasal sinuses are paired holes or cavities in the bones of the face. The cavities are located in the forehead, the cheek bones, between the eyes and above the soft palate. Openings between the sinus cavities and the nose allow mucus and other fluids to drain into the nasal cavity. Since it is one continuous lining in the nose and sinuses, things that cause inflammation in the nose like viral infections and allergies often cause sinusitis. Bacterial sinusitis usually happens after something else has already caused inflammation in the nose.
So why should you care what has caused your nose and sinuses to get plugged? Because most cases of sinusitis are caused by viruses, and viruses aren’t killed by antibiotics. Only a small percentage sinusitis cases are caused by bacteria. Antibiotics only kill bacteria. Antibiotics don’t kill viruses. So for most cases of sinusitis, antibiotics won’t help because most cases of sinusitis are caused by viruses.
So what is wrong with getting an antibiotic anyway, just in case it is bacterial sinusitis? Well, there are two main reasons. As safe and good as most antibiotics are most of the time, all medications, including antibiotic can cause side effects. Do you want to risk a side effect from a medication that wasn’t going to help anyway? The second reason is antibiotic resistance. When we use antibiotics when we don’t need them, we increase the chance that when we do need them, they won’t work.
Okay, so what do I do about my stuffed up head? Start with saline nasal sprays, inhaling steam, and drinking lots of water. These may help the sinuses to drain. Take a pain killer like Tylenol for head and face pain. Oral decongestants like Sudafed and sinutab can be appropriate for some people. Check with your pharmacist if you have uncontrolled high blood pressure, heart problems, or other medical conditions before using them. Nasal sprays like Dristan and Otrivin can be useful as well, but if they are used for more than 3-4 days in a row can cause more congestion than they solve. If allergies are the main cause of the sinusitis, ask your doctor if a nasal spray with a steroid in it is appropriate for you.
How can I tell if I really do need antibiotics? Well, only your doctor can tell for sure, but here are some symptoms of Bacterial Sinusitis:
- thick, colorful nasal discharge
- upper jaw, tooth or facial pain on one side only
- symptoms start to get better and then get worse again
As always if you have any questions or concerns about these or other products, ask your pharmacist.
We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
Is your nose stuffed up and does your head hurt? Are you having trouble breathing and sleeping? Do you feel tired and have trouble hearing? Have you ever felt like that? All of us have felt this way at one point or other and it is unpleasant and a lot of us (including myself) have gone to the doctor and demanded an antibiotic. Well, we may not be doing ourselves any favors.
Sinusitis is an inflammation of the sinuses around the nose (paranasal sinuses). The paranasal sinuses are paired holes or cavities in the bones of the face. The cavities are located in the forehead, the cheek bones, between the eyes and above the soft palate. Openings between the sinus cavities and the nose allow mucus and other fluids to drain into the nasal cavity. Since it is one continuous lining in the nose and sinuses, things that cause inflammation in the nose like viral infections and allergies often cause sinusitis. Bacterial sinusitis usually happens after something else has already caused inflammation in the nose.
So why should you care what has caused your nose and sinuses to get plugged? Because most cases of sinusitis are caused by viruses, and viruses aren’t killed by antibiotics. Only a small percentage sinusitis cases are caused by bacteria. Antibiotics only kill bacteria. Antibiotics don’t kill viruses. So for most cases of sinusitis, antibiotics won’t help because most cases of sinusitis are caused by viruses.
So what is wrong with getting an antibiotic anyway, just in case it is bacterial sinusitis? Well, there are two main reasons. As safe and good as most antibiotics are most of the time, all medications, including antibiotic can cause side effects. Do you want to risk a side effect from a medication that wasn’t going to help anyway? The second reason is antibiotic resistance. When we use antibiotics when we don’t need them, we increase the chance that when we do need them, they won’t work.
Okay, so what do I do about my stuffed up head? Start with saline nasal sprays, inhaling steam, and drinking lots of water. These may help the sinuses to drain. Take a pain killer like Tylenol for head and face pain. Oral decongestants like Sudafed and sinutab can be appropriate for some people. Check with your pharmacist if you have uncontrolled high blood pressure, heart problems, or other medical conditions before using them. Nasal sprays like Dristan and Otrivin can be useful as well, but if they are used for more than 3-4 days in a row can cause more congestion than they solve. If allergies are the main cause of the sinusitis, ask your doctor if a nasal spray with a steroid in it is appropriate for you.
How can I tell if I really do need antibiotics? Well, only your doctor can tell for sure, but here are some symptoms of Bacterial Sinusitis:
- thick, colorful nasal discharge
- upper jaw, tooth or facial pain on one side only
- symptoms start to get better and then get worse again
As always if you have any questions or concerns about these or other products, ask your pharmacist.
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