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Archive for the ‘Plain City Health’ Category

What You Should Know About Probiotics. By Our Student Pharmacist, Malcolm White.

What are Probiotics?

Probiotics have been termed “good bacteria”. Probiotics usually refer to live bacteria in the gut that naturally live in your body. You might be wondering if having this bacteria in your gut will make you sick. The answer is no.

Remember when I said there is a term called good bacteria? Many bacteria in the gut help with processes such as digestion, as well as make important substances like Vitamin K. Your body uses vitamin K for clotting your blood.

Your gut, however, can also consist of bad bacteria. When you get an infection there is usually more bad bacteria, knocking your system out of balance. This is where probiotics can come into play. Good bacteria help eliminate extra bad bacteria thus returning your system back to balance.

How do probiotics work?

The main goal of probiotics is to help restore balance in your gut between the good bacteria and bad bacteria. Your body works constantly to prevent the increased growth of bad bacteria. When you have an increase in bad bacteria you are more likely to become sick. Good bacteria help keep bad bacteria from overgrowing which allows you to stay healthy. This balancing act is constantly happening all of the time. A way to keep your good bacteria in check is by eating a well balanced diet rich in fiber.

Should I take probiotics?

Currently, the main job of probiotics is to help digest food, relieve constipation, decrease diarrhea, and boost immunity. If any of these experiences are a common thing for you I would recommend you try probiotics to help.

Be wary of probiotic products that make claims such as weight loss and reduced cancer risk. Those claims have not been validated. There is evidence that probiotics can treat certain medical conditions.

Wilkins T, Sequoia J. states, “There is high-quality evidence that probiotics are effective for acute infectious diarrhea, antibiotic-associated diarrhea, and clostridium difficile-associated diarrhea (C-Diff).”

Are there any risks to taking probiotics?

For the most part, probiotics have been used safely for years. However, there are some concerns to be aware of when taking probiotics. Exercise caution with use from immunocompromised (having a weakened immune system) patients. Some examples of immunocompromised patients are individuals with cancer, HIV, or previous bone or organ transplant recipient. Because probiotics consist of live bacteria, there is a chance that an immunocompromised patient’s experience with probiotics could be fatal. Also probiotics are not recommended in patients who are lactose intolerant (have a sensitivity to milk).

What are the reliable probiotic brands?

Probiotics are considered dietary supplements not drugs, Therefore, the FDA does not monitor manufacturing of probiotics. This is a major reason why it is important to buy your probiotics from a reliable brand.

Below is a list of probiotics that were recommended by a dietician:

  • Culturelle daily probiotics
  • Gardens of life raw probiotics for women
  • Renew Life
  • Klaire Labs
  • Innate response 14-20
  • Advanced Naturals
  • Seed

What are the ways I can take probiotics?

Probiotics can come in a variety of forms such as:

  • Food
  • Drinks
  • Capsules or Pills
  • Powders
  • Liquids

When using probiotic products, it’s important to store them in the proper place. Some probiotic products are sensitive to heat, light, and humidity. If probiotics are exposed to these elements, they will start to break down thus becoming ineffective to use. Recommended storage would be a dark cool place like a cabinet. Also, remember to look at the product to see if it requires refrigeration.

In conclusion, don’t start taking probiotics without talking to your doctor or pharmacist about whether probiotics might help you.


References: 

Probiotics. Cleveland Clinic.https://my.clevelandclinic.org/health/articles/14598-probiotics. Updated 03/09/2020 Accessed 08/19/2020

Wilkins T, Sequoia J. Probiotics for Gastrointestinal Conditions: A Summary of the Evidence. Am Fam Physician. 2017;96(3):170-178.

Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis. 2015;60 Suppl 2(Suppl 2):S129-S134. doi:10.1093/cid/civ085

Should you take probiotics.https://www.health.harvard.edu/staying-healthy/should-you-take-probiotics. Published April 2016. Updated August 20th, 2019. Accessed August 19,2020.

Kellie Bramlet Blackburn.Should you take a daily probiotic supplement.https://www.mdanderson.org/publications/focused-on-health/should-you-take-a-daily-probiotic-supplement-.h16-1592202.html. Accessed August 19,2020 

Risks and Benefits of Probiotics.WebMD.https://www.webmd.com/digestive-disorders/probiotics-risks-benefits#2. Updated May 12, 2019 Accessed August 19, 2020 

Sydney Greene.The 7 Best Probiotics According to a Dietician.https://www.verywellfit.com/best-probiotics-4163636.Updated 02,2020.Accessed 08/20/2020

Picture References:

Amazon.Renew Life – Ultimate Flora Probiotic Women’s Care – 25 billion – probiotics for women – daily digestive and immune health supplement – 30 vegetable capsules.https://www.amazon.com/Renew-Life-Womens-Probiotic-Supplement/dp/B004ZNDFIW. Accessed August 20,2020

Renew Life.Ultimate flora extra care probiotic 50 billion (14 caps).https://www.renewlife.com/ultimate-flora-extra-care-probiotic-50-billion.html. Accessed August 20,2020

Amazon.Klair Labs – Klaire Labs Ther-Biotic Complete Probiotic – 25 Billion High CFU Probiotic for Women & Men – 12 Species – Digestive Health and Immune Support – Hypoallergenic and Dairy Free (60 Capsules).https://www.amazon.com/Klaire-Labs-Ther-Biotic-Complete-Probiotic/dp/B00JZ246S6. Accessed August 20, 2020

Everything about Asthma – Information so Good it’ll Take your Breath Away. By Our Student Pharmacist, Cat Mechler.

What is asthma?

Asthma is an inflammatory condition where something causes the airway to get blocked, inflamed, and possibly produce mucus, making it difficult to breathe.(1)

Asthma severity varies greatly. It can range from being mild to interfering with your daily life. Sometimes your symptoms can get progressively worse, known as an asthma attack.(1) A severe attack can be life threatening. There is treatment that will help control these symptoms and limit the number of asthma attacks you have. It is very important to work with your doctor to keep your asthma under control!

What causes asthma?

There are many different things that can trigger a person’s asthma, including:(2)

  • Pollen
  • Dust
  • Pets
  • Mold
  • Smoking
  • Pollution
  • Cold air
  • Being sick
  • Strong odors

 

Asthma #1 2

How common is it?

Bronchial asthma is the most common type of asthma and it typically presents in children less than 20-years-old. In the United States, it is the most common chronic condition with 1 of every 12 children having asthma.(1)

What are some symptoms of asthma?

Each type of asthma will have its own unique set of symptoms, but some of the common symptoms include:

  • Wheezing
  • Coughing
  • Chest tightness
  • Shortness of breath
  • Difficulty talking

Asthma #2 2

 How is asthma treated?

Your doctor might decide you need an inhaler to help control your asthma. There are two main types of inhalers to be used in different situations:

  • Rescue inhalers:
    • These inhalers provide rapid relief and can be used during an asthma attack.
    • The most common rescue inhaler is albuterol (ProAir, Ventolin, Proventil).
  • Maintenance inhalers:
    • These inhalers are important for controlling your asthma and preventing you from having asthma attacks in the first place. They do require daily or twice daily administration to work.
    • There are single ingredient products and combination products. Depending on the severity of your asthma, your doctor will decide what treatment is the best for you. There are different formulations that these products are available in, such as a metered dose inhaler (MDI), dry powder inhaler (DPI), and many others.
  • Some people may just need a rescue inhaler, while others will need a maintenance inhaler or two to control their asthma. Treatment selection is individualized to each person.

Asthma #3 2

What’s the difference between MDIs, DPIs, and the other inhalers?

Each inhaler formulation has a specific technique that is required for proper administration and to make sure the medicine is actually getting into your body. Without proper technique, it’s as if you didn’t even take the medicine in the first place.

  • Metered dose inhalers (MDIs) are a common inhaler type used in asthma. The National Asthma Council has instruction on how to properly properly administer MDIs:(3)
  1. Remove cap.
  2. Hold inhaler upright and shake well.
  3. Breathe out all the way.
  4. Put mouthpiece between teeth and close lips to form good seal.
  5. Start to breathe in slowly through mouth and at the same time press down firmly on canister.
  6. Continue to breathe in slowly and deeply.
  7. Hold breath for 10 seconds and remove inhaler from mouth.
  8. Breath out gently.
  9. Repeat if an additional dose is needed.
  10. Replace cap.

  • If the inhaler contains a corticosteroid, you want to make sure you rinse your mouth out after using it.
  • Sometimes the timing of administration is difficult. With MDIs you can use a spacer if needed. A spacer attaches right to your inhaler and acts as a holding chamber that allows you to breathe in the medicine easier.(4)

There are a lot of different inhalers that may have their own techniques to use. There are how-to guides available from the National Asthma Council where you can watch videos of how to use your specific inhaler. Of course, if you’re ever unsure of how to properly use your inhaler, ask the pharmacist!

References:

The Evolution of Smoking: All You Should Know about E-Cigarettes. By Our Student Pharmacist, Malcolm White.

The war on tobacco started in 1964 with the Surgeon General landmark report titled, Nicotine Effects on Smoking and Health.

Following the report, anti-tobacco campaigns on quitting strategies and legislation helped decrease the use and reduce the appeal of tobacco products. One would say that the war on tobacco was successful. However, in the past few years the use of tobacco has increased. This increase has contributed to the use of electronic nicotine delivery system (ENDS).

ENDS is an e-cigarette, also known as vape pen, e-cigars, vaping devices, mod systems, or pod systems. ENDS products contain a flavor solution that also often contain nicotine to produce an aerosolized mixture. These devices are very appealing and popular among youth and young adults.

Are e-cigarettes safe?

The safety of e-cigarettes is unknown at this point. There are currently multiple studies being conducted to answer this question.

So far, this is what we know about vape products.

First, ENDS do not contain many of the carcinogens found in conventional tobacco products. However, they do contain many chemicals that appear to be equally or even more damaging. These chemicals include volatile organic compounds (VOCs) which can lead to eye, nose, throat irritation, headaches, as well as nausea. There have been a few reports that believe e-cigarettes cause damage to the liver, kidney, and nervous system. Some reports show that e-cigarettes produce formaldehyde, which is a cancer causing substance. There is even evidence that shows flavoring chemicals are linked to serious lung disease.

What long term complications are associated with e-cigarettes?

E-cigarettes were first approved in the United States in 2008. In 2016, the Center for Tobacco Products was given authority to regulate e-cigarettes as tobacco products. Based on this short timeline, the product has not been on the market long enough to observe the long term effects associated with e-cigarettes. Some recent reports have shown e-cigarettes to cause serious lung disease in some people.

Do e-cigarettes deliver a consistent nicotine concentration? 

No, recent findings show that e-cigarettes can deliver high concentrations of nicotine. E-cigarettes which provide inconsistent levels of nicotine delivery pose health concerns for the user. Increasingly, there have been reports of nicotine overdose in users.

Can vape help with quitting tobacco attempts?

A major statement that is used to market e-cigarettes is the thought that they will help smokers quit. There are studies that showed e-cigarettes decrease nicotine consumption while other studies showed little to no evidence to support they assisted with helping individuals quit.

When reviewing the studies on this statement, many studies were flawed because of two factors.

First, the studies enrolled patients who had no intention of quitting.

Second, the e-cigarettes could not be counted on to provide consistent levels of nicotine.

These two factors, therefore, show that there have not been any appropriate studies performed that prove e-cigarettes help with smoking cessation. The U.S. Preventive Services Task Force concludes that the current evidence is insufficient to recommend ENDS for smoking cessation.

My interpretation of the data is that ENDS could potentially, in the future, be used as a device to help smokers quit who are highly motivated to quit.

Worku., D. & Worku, E. report that, in motivated smokers with clinician support, e-cigarettes can provide superior outcomes than traditional nicotine replacement therapy (NRT), but these results need further confirmation.

Currently, I would still recommend smokers use conventional resources (NRT) when it comes to helping them quit.

Smoking Cessation

Clinically, behavior therapy, as well as NRT, is recommended to help an individual stop smoking.

An individual looking to quit smoking should seek out a motivational or coaching program dedicated to helping individuals quit. If one can not be found, regularly scheduled therapy visits can suffice as a replacement. Be wary of programs that charge high fees. Smoking Cessation services are usually free or low cost.

The next step would be to talk to your doctor about prescription or over-the-counter nicotine replacement therapy. NRT products range from patches, to gums, to inhalers.

Both therapies should be used together to help increase your chance of successfully quitting.

Smoking Cessation Resources:

CDC Free quit help:

1-800-QUIT-NOW or 1-800-787-8669

CDC How to Quit Smoking Campaign – offers quit plans, tips from former smokers, and quitSTART app

https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/index.html

Smokefree.gov’s Make Your Quit Plan

https://smokefree.gov/build-your-quit-plan

American Cancer Society’s Great American Smokeout

https://www.cancer.org/healthy/stay-away-from-tobacco/great-american-smokeout.html

NiAnon by Recovery.org

https://www.recovery.org/support-groups/smokers-anonymous

QuitLogix – Offers coaching and an online support community.

https://helpline.quitlogix.org/en-US/Just-Looking

NSW Cancer institute and Quitline Team

Quit Kit and a diary to help you quit smoking

https://www.icanquit.com.au/media/QuitKit/QuitKit.pdf

References:

Nicole van Hoey. Nicotine addiction and the evolution of tobacco products: How can pharmacists counter new trends? America’s Pharmacist. Published April 2, 2020 Accessed August 11, 2020

E-Cigarettes. American Academy of Pediatrics. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Richmond-Center/Pages/Electronic-Nicotine-Delivery-Systems.aspx. Published … Accessed August 11, 2020

The American Cancer Society Medical and Editorial Team. What Do We Know About E-cigarettes? American Cancer Society. https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html.Published November 19, 2019 Accessed August 11, 2020

Jenssen BP, Wilson KM. What is new in electronic-cigarettes research?. Curr Opin Pediatr. 2019;31(2):262-266. doi:10.1097/MOP.0000000000000741

Bhalerao, A., Sivandzade, F., Archie, S.R. et al. Public Health Policies on E-Cigarettes. Curr Cardiol Rep 21, 111(2019). https://doi-org.proxy.lib.ohio-state.edu/10.1007/s11886-019-1204-y 

Farsalinos K. Electronic cigarettes: an aid in smoking cessation, or a new health hazard?. Ther Adv Respir Dis. 2018;12:1753465817744960. doi:10.1177/1753465817744960

Worku, D., & Worku, E. (2019). A narrative review evaluating the safety and efficacy of e-cigarettes as a newly marketed smoking cessation tool. SAGE Open Medicine. https://doi.org/10.1177/2050312119871405

Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions. U.S. Preventive Services Task Force Published June 02, 2020  Accessed. August 14, 2020

 

Picture References: 

E-Cigarette Dangers – 5 facts you need to know. Columbia Doctors Nurse Practitioner Group.https://www.columbianps.org/healthy-life-blog/e-cigarette-dangers-5-facts-you-need-to-know/. Published September 24, 2019 Accessed September 12, 2020 

https://www.columbianps.org/healthy-life-blog/e-cigarette-dangers-5-facts-you-need-to-know/

Curr Opin Pediatr. Author manuscript; available in PMC 2020 Apr 1.Published in final edited form as:Curr Opin Pediatr. 2019 Apr; 31(2): 262–266.doi: 10.1097/MOP.0000000000000741

Components of the e cigarettes components:

Rom, O, Pecorelli, A, Giuseppe, Vet al. Are E-cigarettes a safe and good alternative to cigarette smoking. Ann N Y Acad Sci 2015; 1340: 65–74.

 

Allergy Relief? Sinus up! By Our Student Pharmacist, Cat Mechler.

What are allergies?

Allergies are a result of your body overreacting to foreign objects, that we call allergens. Seasonal allergies are fairly common as there are many allergens that can trigger an allergic reaction, including(1):

  • Pet dander
  • Dust mites
  • Grass
  • Weeds
  • Trees
  • Mold

Symptoms of seasonal allergies are similar to those of a cold and include(1):

  • Itchy/watery eyes
  • Congestion
  • Runny/itchy nose
  • Sneezing
  • Skin rash

Allergy #1

When can I get allergy symptoms?

Typically, allergies can begin as early as the end of February and last until the end of the summer. However, you may experience these symptoms at any time during the year, depending on where you are in the country. The specific allergen that’s triggering your allergies can also affect when you get them.(2)

What can I do to treat them?

The best thing you can do to prevent these symptoms is to avoid the allergen. Monitoring pollen counts, keeping windows and doors shut, and taking a shower after you’ve been outside during allergy season are a few ways to help minimize your risk of experiencing allergy symptoms.(2)

It’s not always possible to completely avoid triggers. There are a variety of options that can be found over the counter (OTC) to help control your allergies. At first, the amount of OTC allergy products can seem overwhelming; however, there are generally 5 different types of products to choose from:

  1. Glucocorticoid nasal sprays are the most effect single treatment to help relieve(3):
    • Congestion
    • Runny/itchy nose
    • Sneezing

These nasal sprays may cause local irritation, including drying or burning of the nose or throat. Another important thing to know is that these medications can take several days to weeks of daily use to see the full effects.

Examples include:

  • budesonide (Rhinocort)
  • fluticasone propionate (Flonase)
  • triamcinolone (Nasacort)

Allergy #2

Be careful not to pick out a nasal decongestant spray, like phenylephrine or oxymetazoline. These are not recommended for the routine treatment of seasonal allergies.

  1. Nasal Saline – Saline spray or irrigation can be beneficial for milder symptoms and offers some relief for:
  • Runny nose
  • Itchy throat
  • Congestion

It’s important to remember if using the nasal saline irrigation to always use distilled, sterilized, or boiled water that has cooled to room temperature to kill any potentially infectious organisms.(4)

Allergy #3

  1. Oral antihistamines – Good option if you’re looking for something to help control mild to moderate symptoms, especially:
    • Itching
    • Sneezing
    • Runny nose

These medications are less effective for congestion in comparison to the glucocorticoid nasal sprays.(5) Additionally, antihistamines often cause sleepiness. First generation antihistamines, including diphenhydramine (Benadryl), are more sedating than others. Typically, second generation oral antihistamines are less sedating and are therefore preferred to help treat allergy symptoms.

Less sedating second generation antihistamines include:

  • cetirizine (Zyrtec)
  • levocetirizine (Xyzal)
  • loratadine (Claritin)
  • fexofenadine (Allegra)

Some other side effects of these medications could include dry eyes and mouth.

Allergy #4

  1. Antihistamine eye drops – Option that offers relief for itchy or red eyes

Refrigeration or using refrigerated artificial tears prior to the antihistamine eye drops may help to reduce burning/stinging sensation upon installation. Other side effects could include increased eye dryness or headache. (6)

Examples include:

  • ketotifen (Alaway or Zaditor)
  • olopatadine (Pataday)

Allergy #5

 

  1. Artificial tears are another option to help with dry eyes that would in turn reduce redness.

Of course, if you’re having trouble picking the product that will work best for you, feel free to ask the pharmacist!

Sometimes OTCs aren’t enough to control your allergies and you might have to go to a doctor who specializes in allergy control. They might suggest immunotherapy or allergy shots. These are very effective in treating your persistent allergy symptoms and may even make you “less allergic” over time.(2)

References:

 

All Your Questions and Concerns About CBD. By Our Student Pharmacist, Malcolm White.

Have you heard about CBD? Recently, CBD has become increasingly popular. You might have seen CBD products advertised at your local grocery and pharmacy. The CBD rage is due to the many potential benefits it has for easing symptoms of insomnia, anxiety, chronic pain, and a host of other health conditions.

What is CBD?

CBD, short for cannabidiol, is a plant-based compound known for its calming effects. CBD comes from hemp and cannabis plants. CBD is made by extracting CBD from the cannabis plant and then diluting it with another type of oil, such as coconut oil or hemp seed oil. CBD is a 100% natural product with no psychoactive effects.

The following information comes from Ananda Professional:

Does CBD get you high?

No, CBD is derived from the cannabis plant and is made up of two main players: CBD and THC. CBD is the non-psychoactive portion of the plant. What that means is you won’t have any effects like euphoria. Therefore, you will not feel “high” in any way when taking CBD.

Will CBD show up on a drug test?

No, a product that contains CBD alone will not trigger a positive drug test. Most drug tests screen for the compound delta-9-tetrahydrocannabinol (THC). You do want to research reputable CBD brands that have third party testing. Below will be a list of reputable places to purchase CBD.

Is CBD legal?

Yes and no. CBD is legal to sell or consume in all 50 states except Idaho, South Dakota, and Nebraska.

It is legal in Ohio.

CBD side effects

The most commonly reported side effects are:

  • fatigue
  • diarrhea
  • changes in appetite

CBD forms

As the hype around CBD increases, consumers are finding a wide variety of ways to consume it. The most common form of CBD products include oils. You could also see popular food brands and restaurants adding CBD to their products.

Common forms include:

  • CBD Oil
  • CBD Gummies
  • CBD Topicals/Lotions/Sprays
  • CBD Capsules
  • CBD Sleep Aids
  • CBD Pet Products
  • CBD Bath Bombs
  • CBD Candy
  • CBD Patches
  • CBD Toothpicks

IMG_1991

What can CBD treat?

CBD has been promoted to manage a wide range of health issues. Many research trials are currently in progress or needed to show scientific evidence that CBD is effective in treating and managing these wide range of health issues. Currently, there is strong scientific evidence in the effectiveness of CBD to treat some severe childhood epilepsy syndromes such as Dravet Syndrome and Lennox- Gastaut Syndrome (LGS), which typically don’t respond to antiseizure medications. CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.

CBD also helps to treat:

  • Pain and inflammation seizures
  • Anxiety
  • Depression
  • Nausea
  • Migraines
  • Psychosis Mental Disorder

Is CBD good for pain management?

Based on scientific data and requirements, it’s unknown due to the lack of studies conducted. Currently, there is an overwhelming body of convincing preclinical evidence indicating that cannabinoids are effective in treating pain for rodent test subjects. The next steps are to conduct trials using human subjects to show effectiveness in treating challenging chronic pain.

CBD drug interactions with common interactions

Current research shows that CBD is generally safe. However, CBD does have the potential to interact with some medications.

Some medications with moderate interactions include:

  • Plavix: Clopidogrel
  • Valium: Diazepam
  • Lexapro: Escitalopram
  • Prevacid: Lansoprazole
  • Prilosec: Omeprazole

Before trying CBD, it’s crucial to talk to your doctor or local pharmacist about all of the vitamins, supplements, prescriptions, and over-the-counter medications you’re taking. You never know how your body will react to a product. Therefore, when taking CBD for the first time, do so safely under supervision.

Reputable CBD Brands

The following are websites of trusted brands that may be the best place to find CBD oil. These websites provide you with third-party lab reports and all the key product details.

The above products are located and can be purchased at Happy Druggiest on Karl Rd.

CBD for Pets

More people are looking for new ways to help their pets. Many pet owners wonder if CBD is okay for pets. Because mammals, including cats and dogs, all have similar central regulatory systems, CBD can provide relief for them with some health issues including:

  • Arthritis
  • Separation anxiety
  • Nausea and vomiting
  • Noise phobias
  • Hip and joint mobility
  • Everyday health and wellness

For those looking for a natural alternative to provide relief, CBD may support a wholesome wellness regimen.

References:

  1. Iffland K., Grotenhermen F. An update on safety and side effects of cannabidiol: A review of clinical data and relevant animal studies. Cannabis Cannabinoid Res. 2017;2:139–154. doi: 10.1089/can.2016.0034.

  2. VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ Guide to Cannabidiol and Hemp Oils. Mayo Clin Proc. 2019;94(9):1840-1851. doi:10.1016/j.mayocp.2019.01.003

  3. Peter Grinspoon MD. Cannabidiol (CBD) what we know and what we don’t. Harvard Health publishing Harvard Medical School https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 Published, August 24th, 2018, Accessed August 5th, 2020

  4. John Rampton. CBD Guide: 12 Important Facts You Should Know Right Now. Green Entreprenuer. https://www.greenentrepreneur.com/article/333543 Published May 10th, 2019, Accessed August 5th, 2020

  5. Jennifer Chesak, CBD and Drug Interactions: What You Need to Know. Healthline.https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-knowPublished November 15th, 2019, Accessed August 5th, 2020

  6. Jillian Kubala, 7 Benefits and Uses of CBD Oil (Plus Side Effects). Healthline.https://www.healthline.com/nutrition/cbd-oil-benefits Published February 26th, 2018, Accessed August 5th,2020

  7. Nova Recovery Center, Everything You Need to Know About CBD.https://novarecoverycenter.com/drug-use/what-is-cbd/ Published February 15th 2019, Accessed August 5th 2020

  8. Ananda Professional. A 600mg tincture CBD bottle. Ananda Professionals https://www.anandaprofessional.com/ Accessed August 6th, 2020