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Archive for the ‘Plain City Health’ Category

Prescription “Take-Back” Day is Saturday, April 27 from 10 am to 2 pm.

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The National Prescription Drug Take-Back Day will take place on Saturday, April 27 from 10 am to 2 pm. During this yearly event, you can turn in old or no longer used medicines for proper disposal. We know that many of you may have medications that have expired or that you don’t take any more and this is a perfect way to make sure they are destroyed so that no one gets hurt.

To find out more about the Take-Back Day, visit the web site HERE.

To find a disposal location near you, go HERE and put in your zip code or county and city.

In Union County, you can turn in unused and expired medications at these sites:

Union County Sheriff’s Office

221 West 5th Street, Marysville, OH 43040 (Please enter the sally port from the south off of 6th St. Signs will be posted).

Pleasant Valley Fire Department

650 West Main Street, Plain City, OH 43064 (Please enter the rear of the bays).

Richwood Police Department

153 North Franklin Street, Richwood, OH 43344 (Please enter the sally port entrance).

Tips to Keep You and Your Medications Safe as Temperatures Rise. By Our Student Pharmacist, Cambree Fillis.

With temperatures outside rising, it is important to keep yourself and your medications safe!

Certain medications can increase the sensitivity of our skin to the sun, cause heat intolerance, and promote dehydration. Medications themselves can also be damaged by the sun, heat, and humidity.

Hydration Image

Keep yourself safe:

Due to varying mechanisms of action and side effects of certain medications, you may be at an increased risk of sunburn, heat intolerance, and/or dehydration. Medications that make the skin more prone to sunburn include, but are not limited to, antibiotics, antifungals, antihistamines, and NSAIDs. For a more comprehensive list, please refer to the end of this article.*

These medications may cause a severe burn, hives, rash, and an increased risk of skin cancer if you spend any amount of time in the sun without protection. To reduce the risk of this adverse event, take protective measures against the sun. Find shade, stay covered, and apply the appropriate sunscreen. Check back later this month for an article on how to stay safe in the sun!

Some medications can also cause heat intolerance. Tricyclic antidepressants, such as amitriptyline, and antihistamines, including Benadryl, cause individuals to sweat less. This increases internal body temperatures and results in an increased risk of heat intolerance. Beta blockers, typically used for blood pressure or heart rate control, reduce blood flow to the skin. This also increases the risk of heat intolerance. Overheating due to heat intolerance can lead to heat stroke, characterized by symptoms of nausea, vomiting, changes in heart rate, confusion, and fainting. To reduce the risk of heat intolerance, stay hydrated, seek shade or air conditioning, and avoid strenuous physical activities outside.

Medications, including water pills, such as furosemide and other diuretics, work by eliminating fluid from the body and increasing the risk of dehydration. Laxatives also increase the risk of dehydration due to fluid loss. These medications, in addition to too much fun in the sun without the proper hydration, can be a dangerous combination. A good way to reduce the risk of dehydration is by maintaining an adequate fluid intake and avoiding alcoholic beverages.

Reach out to your pharmacist if you have questions regarding if these side effects are common for any of your current medications.

Medication Image

Keeping your medications safe:

It is also important to consider any and all products that are temperature sensitive themselves, to ensure safety and effectiveness. Medications that are required to be stored under refrigeration should be kept around 35-40°F. Those that are to be stored at room temperature should be kept around 75-77°F, away from humidity and light. If a medication should be kept at room temperature it is best to store it in a cabinet or a drawer outside of the bathroom and out of the reach of children and pets. This storage prevents exposure to fluctuating temperatures and humidity. Otherwise, these medications can lose their potency and effectiveness, meaning you are not receiving the appropriate therapeutic amount of medications. If you do not receive therapeutic doses of insulin, blood sugar may drastically increase; if you do not receive therapeutic doses of antibiotics, infections may worsen or become resistant.

Although there may not always be a physical sign, some medications may have noticeable changes if they are damaged by the heat. Changes in smell, taste, color, and form may be observed. If you notice any of these changes, call your local pharmacy to ask questions and request refills.

0Medications that have not been stored correctly should be disposed of properly. Various police stations and fire departments have drop off boxes to dispose of damaged and/or expired medications. Additional locations will take back medications on national prescription drug take-back day, which will take place this year on Saturday, April 27, 2019 from 10:00am. to 2:00pm. Otherwise medications may be disposed of by mixing them with cat litter or coffee grounds and throwing the mixture into the garbage.

Additional tips to keep your medication safe:

  • Do not leave medications in the car.
  • If you are traveling, keep your medications in a cooler or insulated bag.
  • If you are traveling by plane, keep your medications in your carry-on; use a cool pack if needed.
  • Travel with only as much medication as you need for the trip.
  • If you wear an insulin pump, consider changing the insulin more frequently in the summer.

Ask your pharmacist if you have any questions regarding a medication that may have been stored incorrectly.

* Antibiotics: ciprofloxacin, levofloxacin, ofloxacin, doxycycline, tetracycline, sulfamethoxazole/trimethoprim (Bactrim)

Antifungals: voriconazole, itraconazole, fluconazole, griseofulvin

Antihistamines: cetirizine, diphenhydramine, loratadine, cyproheptadine

Cholesterol lowering agents: simvastatin, atorvastatin, lovastatin, pravastatin

Diuretics: hydrochlorothiazide, chlorthalidone, chlorothiazide, furosemide, triamterene

NSAIDs: ibuprofen, naproxen, celecoxib, ketoprofen

Oral contraceptives and estrogens

Antiemetics: chlorpromazine, fluphenazine, promethazine, prochlorperazine

Psoralens: methoxsalen, trioxsalen

Retinoids: acitretin, isotretinoin, tretinoin

Sulfonamides: acetazolamide, sulfadiazine, sulfasalazine, sulfisoxazole

Sulfonylureas: glipizide, glyburide

Miscellaneous medications: amiodarone, lamotrigine, quinidine.

Resources:

  1. Harrelson L. Summer Weather Doesn’t Mix With Some Medications. Accessed April 2019. https://www.agingcare.com/articles/medication-affected-by-summer-heat-151887.htm.
  2. Polk County Health Department. Keep Your Medications Away From Summer Heat! Accessed April 2019. https://www.polkcountyiowa.gov/media/189984/medication-handout.pdf.
  3. Rathner JL. Medications Can Make You More Sun and Heat Sensitive. Accessed April 2019. Published August 2012. https://www.lhsfna.org/index.cfm/lifelines/august-2012/medications-can-make-you-more-sun-and-heat -sensitive/.
  4. Stoller-Conrad J. Why you should keep medicines out of the summer heat. Accessed April 2019. Published July 2012. https://www.npr.org/sections/health-shots/2012/07/10/156575072/why-you-should-keep-medicines-out-of- summer-heat.
  5. Tunno BB. Heat and medication: pharmacists share tips to keep your prescriptions safe. By Bianca Barr Tunno, AccuWeather staff writer. Accessed April 2019. https://www.accuweather.com/en/weather-news/how-does-heat-affect-medications/70001730.
  6. US Food and Drug Administration. The Sun and Your Medicine. Accessed April 2019. Updated September 2015. https://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm464195.htm

 

Vitamin D Deficiency. By Our January Student Pharmacist, Brayson Ramirez.

During the winter months here in Ohio it can be hard to get enough sunlight. The days are short and the weather is usually too terrible to wear shorts or a t-shirt. According to The New England Journal of Medicine, adequate sun exposure is considered direct sunlight to the arms and legs for five to thirty minutes between 10 am and 3 pm twice a week. The weather can be unpredictable, but I know I don’t go outside anywhere close to that much during the winter, even with only my face exposed.

Image 4

There are three significant factors that contribute to Vitamin D absorption, or lack thereof:

  • The first factor is skin tone; the darker the skin the harder it is to absorb the UVB rays needed to make Vitamin D.
  • The second factor is weight; the heavier a person is, the less likely they are to produce an adequate amount of Vitamin D.
  • Lastly, age is a contributing factor. Once a person reaches 50 years old, the body doesn’t produce Vitamin D at the same rate.

Rickets, osteoporosis, a weakened immune system, and general fatigue can be caused by a lack of Vitamin D. Each one of these complications is particularly harmful to older adults. Unfortunately, women are prone to bone density issues, such as osteoporosis, so they greatly benefit from maintaining a good level of Vitamin D.

The Centers for Disease Control and Prevention (CDC) reports that at any given time 10% of the population is Vitamin D deficient. In the study where they determined this number, the people they tested were from the northern areas during the summer and the southern areas during the winter. With that selection process in mind, the number of Ohioans during the winter who are Vitamin D deficient is most likely much greater than 10%.

Image 2

Taking Vitamin D without an official Vitamin D deficiency diagnosis is okay and recommended by many doctors, but you must make sure to not over do it. If you wanted to take Vitamin D if you know you are not getting enough sunlight, the recommended dosing for an adult is 800 to 1000 units once a day. Doctors commonly prescribe more, but they can run blood tests to have a better idea of how much Vitamin D their patients need.

Image 3

When you go to the pharmacy to get your Vitamin D supplement you will most likely come across many choices with many strengths. There will also probably be a Vitamin D2 (ergocalciferol) and a Vitamin D3 (cholecalciferol). Both types are very similar in structure and are safe to use. They are not quite equivalent though. Vitamin D2 originates from plants while Vitamin D3 is what animals, including humans, produce from the sun. Both types are eventually converted by the liver to the same chemical that is used in the body, but some studies show Vitamin D3 produces more of that useable chemical per dose and helps to maintain a higher level in the body. If you are currently using D2 and it is working well for you then there would be no reason at all to change it. When it comes to which one to use, I would pick D3, but if I went to the store and there was a significant cost difference or no D3 options I would go ahead and use D2.

Hopefully, this information can help you understand Vitamin D and why many people are trying to replace it through supplementation.

Continuous Glucose Monitors, a Pharmacy Perspective. By Our January Student Pharmacist, Brayson Ramirez.

Checking blood sugar with finger sticks throughout the day may not be the worst part of diabetes, but it is possibly the most well-known. Finger sticks always have discomfort associated with them and nobody likes to poke themselves to draw blood, no matter how small the sample. The ability to test blood sugar without having a finger stick sounds like a dream solution to a problem affecting such a large number of people. Continuous glucose monitors, or CGMs for short, are trying to offer this option.

Image 1

Recently a new product has come to the market and has been gaining popularity in this area, but why? Continuous glucose monitors have been around for a while, but lancets and test strips have not gone away. I wanted to take this chance to look at the continuous glucose monitors from a pharmacy perspective.

There are a couple of very important variables with CGMs that are commonly not considered or well-advertised. The first is the warm-up period of the monitor system. During this time, the sensors are not guaranteed to produce accurate data, so it would not be recommended to use those readings for insulin administration or glucose record keeping.

The second variable is the calibration of the sensors as recommended by the manufacturer. In order to have the most accurate readings, calibration is required. To calibrate a sensor, a traditional finger stick reading is required. In some cases, the calibration finger sticks may be even more poking and prodding than a traditional blood glucose testing schedule.

I went through some of the more popular CGMs and made a quick summary chart of their warm-up and calibration requirements along with their life span. The products listed do not include insulin pumps that can integrate with sensors to get glucose readings.

Chart 1

As you can see from the chart, the Freestyle Libre system is the only one that does not require the user to calibrate, so it is the most likely to reduce finger sticks. All of the systems require a warm-up period. Again, the Freestyle Libre does show a bit of an improvement in this area. It has a one hour warm-up time, but it has a sensor life of 14 days, so that warm-up time will be coming around less frequently.

Image 2

When it comes to accuracy with continuous glucose monitors and traditional blood glucose meters, it is very important to understand how each works. Blood glucose meters are basically taking a snapshot of your current glucose level. CGMs measure glucose levels with interstitial glucose that is basically leaking out of your blood vessels, as seen in the above image. Since the interstitial glucose is not a direct measurement of blood glucose, the values are more like delayed blood glucose levels. With this delay, CGMs are not the best in a situation where glucose is rapidly changing, such as a severe high or low glucose reading that you are trying to recover from. In those cases, finger stick glucose readings are going to be more accurate and potentially avoid an even more serious situation.

Continuous glucose monitors have been shown to produce better outcomes overall for diabetic patients due to their more constant monitoring, but it is still necessary to keep a supply of traditional testing supplies for emergencies or sensor malfunctions.

The DASH Diet. By Our January Student Pharmacist, Brayson Ramirez.

At this point, we are a little bit more than a week into 2019. Many people have made New Year’s resolutions and a large chunk of them most likely want to lose some unwanted weight. Weight loss is not a bad idea, but a lot of people do not know how to do it in a healthy way. Some believe eating less is the way to lose weight, but that can be unhealthy and even dangerous.

The best way to lose weight is through diet and exercise, but also keeping in mind what is reasonable and what one is individually capable of doing. Some progress is better than no progress. Some diet changes may show change, but some may just lead to a happier, healthier life.

I recommend focusing on the happier, healthier life and the rest will come with time.

The first place to start a dietary change would be with the DASH diet. This diet has been proven through multiple scientific studies to help lower or prevent high blood pressure and can also help with weight loss and diabetes. The focus of this diet is on foods that have always been considered healthy, such as fruits, vegetables, fish, poultry, and nuts. The DASH diet also tries to keep sodium, sweets, added sugars, and fats in moderation. By adjusting the serving sizes of each group, more nutrients can be ingested while limiting the harmful saturated fats, trans fats, and cholesterol.

Blood Pressure Monitor

To figure out your diet, all you do is check your daily calorie needs for your age and level of activity. Age, is of course self-explanatory, but activity level can be tricky. The DASH diet divides activity level into sedentary, moderately active, and active. Sedentary is only completing your activities to get through the day. Moderately active is walking 1-3 miles a day at a low speed. Active is considered walking more than 3 miles per day and some light physical activity. Females have lower calorie needs on average, as seen in this chart provided by the National Heart, Lung, and Blood Institute (NHLBI).

Chart 1 Calorie Needs

Making this change in diet too quickly can lead to some diarrhea and other uncomfortable problems due to the increase in fiber. Slowly adding a serving or two of vegetables, grains, or fruits each week to transition to the DASH diet can help limit digestive issues and make the change as comfortable as possible.

The hardest part to follow in the DASH diet is knowing the servings needed of each group and what counts as a serving. This is where the diet gets tricky. The NHLBI has a great chart that breaks everything down as shown here.

Chart 2 Food Groups

My advice on this concept is to check out the food groups listed and just try to stay around the top. Maybe try a couple of the meal ideas pre-made on the site or create your own with the recommended food groups. See if there are any meals you enjoy; if you do, start introducing one or two of them every week.

Hopefully, you could get to the point of an all DASH diet approved meal plan, but if you are at least choosing the healthier of two options then that is some important progress. Remember, some progress is better than none and if you are living a happier, healthier life that is most important.

 

For all my reference material and more information on the DASH diet. And for various resources to use in any dietary adjustments please visit https://www.nhlbi.nih.gov/files/docs/public/heart/dash_brief.pdf